Bacitracin ointment prescription

Bacitracin ointment prescription DEFAULT

Bacitracin Topical

Continuing Education Activity

Bacitracin is a topical antibiotic ointment widely used by both medical professionals and the general public to treat minor skin injuries including cuts, scrapes, and burns. Bacitracin can be used as a single agent ointment or in combination as a triple therapy ointment, with neomycin and polymyxin B. The latter can be found over the counter (OTC) at local pharmacies. This activity outlines the indications, mechanism of action, safe administration, adverse effects, and contraindications when using bacitracin.

Objectives:

  • Identify the indications for bacitracin topical.

  • Describe the antimicrobial mechanism of action of bacitracin

  • Review the side effects, contraindications, and interactions of bacitracin topical.

  • Review interprofessional team strategies for improving care coordination and communication to enhance patient outcomes when using bacitracin topical.

Access free multiple choice questions on this topic.

Indications

Bacitracin is a topical antibiotic ointment widely used by both medical professionals and the general public to treat minor skin injuries including cuts, scrapes, and burns.

Bacitracin was discovered in 1945 from a leg injury of a seven-year-old American girl named Margaret Tracey. The collected debris from her wound grew isolates of several related cyclic polypeptides produced by a member of the Bacillus subtilis group. This discovery gave rise to the unique name, bacitracin.[1] 

The United States Food and Drug Administration (FDA) approved the use of bacitracin in 1948 for the short-term prevention and treatment of both acute and chronic localized skin infections. Less frequently, bacitracin can also be given as a parental medication via intramuscular (IM) injection for the systemic treatment of infantile streptococcal pneumonia and empyema. To date, there are no record of any non-FDA approved uses of topical bacitracin.

Bacitracin can be used as a single agent ointment or in combination as a triple therapy ointment, with neomycin and polymyxin B. The latter can be found over the counter (OTC) at local pharmacies.[2] 

Mechanism of Action

Bacitracin is a mixture of several closely related cyclic polypeptide antibiotics that has both bacteriostatic and bactericidal properties depending on the concentration of the drug and the susceptibility of the microorganism. 

Many gram-positive bacteria including Staphylococcus spp., Streptococcus spp., Corynebacterium spp., Clostridium spp., and Actinomyces spp. are susceptible to bacitracin. Some gram-negative organisms, such as Neisseria spp. also exhibit susceptibility; however, most gram-negative organisms are resistant.[3]

Bacitracin readily absorbs through denuded, burned, or granulated skin and works to prevent the transfer of mucopeptides into the cell wall of various microorganisms. This subsequently inhibits bacterial cell wall synthesis and ultimately, bacterial replication. Bacitracin also acts as an inhibitor of proteases and other enzymes involved in altering bacterial cell membrane function. Bacitracin inhibits bacterial cell wall synthesis by preventing the dephosphorylation of P-P-phospholipid carrier that attaches the cell wall peptidoglycan precursor units to the cell membrane, and this leads to bacterial cell lysis.[4]

Administration

Bacitracin is available in three different routes of administration in the USA: topical, ophthalmic, parenteral via IM injection. 

Its most common use is as a topical agent that is administered directly onto the wound or infected area. It can also be administered as a topical ophthalmic ointment to treat superficial ocular infections involving the conjunctiva and cornea.[5] 

Before topical application, the skin should be cleansed gently with mild soap and water. Enough ointment should then be applied to cover the affected area(s), and a sterile dressing can be used to cover the wound. This helps to assist in wound healing and prevent further contamination of the wound site. 

Adverse Effects

When used topically as a single agent ointment or part of a triple therapy ointment, bacitracin, and its drug formulation components may cause allergic contact dermatitis which could lead to an anaphylactoid reaction or anaphylaxis.[6]

Common and mild side effects of the topical use of bacitracin include[2][7]

  • Fever

  • Hives

  • Itching

  • Swelling of lips and face

  • Difficulty breathing

  • Nausea

  • Vomiting

Pregnancy[8]

  • Bacitracin is a pregnancy risk category C.

  • No large studies have been conducted with the use of topical bacitracin during pregnancy or lactation.

  • To date, there is no evidence to suggest that there is an increased risk of adverse fetal development with the use of topical bacitracin. 

Breast-Feeding[9]

  • Topical and ophthalmic forms of bacitracin typically result in minimal absorption through the skin and are considered a low risk to the feeding infant.

  • Only water-soluble creams or gel products should be applied to the breast tissue to prevent infant exposure to mineral paraffin from licking.

Contraindications

Topical bacitracin is contraindicated in anyone with hypersensitivity to bacitracin and/or any of its drug formulation components. Patients with known hypersensitivity to neomycin may also be sensitive to bacitracin.

Bacitracin application on an infection or wound that is caused by a viral or fungal infection may increase the risk for the development of drug-resistant bacteria.  

Topical bacitracin use is recommended only for minor skin injuries and should not be used over larger areas of the body.

Physician consultation is recommended before using topical bacitracin for serious injuries such as burns, deep wounds, puncture wounds, or animal bites.[10][11]

Monitoring

Secondary infections may develop; therefore, topical bacitracin should not be used for more than seven days unless directed by a physician. The area of application should undergo monitoring for improvement. Bacitracin use should be stopped immediately if symptoms worsen and a physician should be contacted regarding further management.

Allergy patch testing may be warranted if an adverse reaction occurs after the use of bacitracin as a single agent ointment or part of a triple therapy ointment. There have been multiple reports of anaphylactoid reactions and anaphylaxis due to bacitracin use.[6][12][13]

Toxicity

There is no mention of toxicity with the topical use of bacitracin as a single agent ointment or part of a triple therapy ointment.

However, the IM route has been shown to cause nephrotoxicity and renal failure due to tubular and glomerular necrosis. Consequently, careful monitoring is in order with the IM use of bacitracin. Renal function should be determined before, during, and after IM administration. Patients' daily optimal fluid intake and urinary output should be followed closely to avoid kidney injury. 

Concurrent use of streptomycin, kanamycin, polymyxin E, and neomycin should be avoided as these drugs are also known to be nephrotoxic.[14][15]

Enhancing Healthcare Team Outcomes

Topical bacitracin has been easily accessible and considered a safe OTC topical antibiotic for the past seven decades. Despite its effectiveness, increases in use and adverse effects led to it earning, in 2003, the undesirable designation “contact allergen of the year” by the American Contact Dermatitis Society. In 2005-2006, it was also ranked the sixth most prevalent allergen in patch tests.[2][16][17][18]

As a result, all healthcare professionals should be aware of the potential risks of an anaphylactoid reaction or anaphylaxis secondary to bacitracin use. Anyone with confirmed contact dermatitis should avoid products containing bacitracin. Providers should encourage their patients to read the labels for bacitracin in ointments, creams, and other wound care products.

Providers should make a habit of inquiring about bacitracin use when encountering a patient with a possible contact allergy or unremitting dermatitis or non-healing wound as bacitracin allergy may present as cellulitis or simple wound infection. One clinical clue to decipher an allergic reaction from an infectious process is the presence of itching instead of worsening pain, respectively. (Level III)

Bacitracin should be used cautiously in patients with pre-existing renal impairment or renal failure. To ensure patient safety, physicians, nurses, and pharmacists, et al.. should work as a team to monitor patients' intake, urinary output, and renal function. Due to the significant risk of nephrotoxicity, pharmacists should provide alternative medication options when available. 

Bacitracin is also present in some veterinary products, and pet owners should also be highly cautious when applying topical bacitracin medications.

References

1.

WRONG NM, SMITH RC, HUDSON AL, HAIR HC. The treatment of pyogenic skin infections with bacitracin ointment. Treat Serv Bull. 1951 Jun;6(6):257-61. [PubMed: 14835814]

2.

Schalock PC, Zug KA. Bacitracin. Cutis. 2005 Aug;76(2):105-7. [PubMed: 16209155]

3.

Johnson BA, Anker H, Meleney FL. BACITRACIN: A NEW ANTIBIOTIC PRODUCED BY A MEMBER OF THE B. SUBTILIS GROUP. Science. 1945 Oct 12;102(2650):376-7. [PubMed: 17770204]

4.

Stone KJ, Strominger JL. Mechanism of action of bacitracin: complexation with metal ion and C 55 -isoprenyl pyrophosphate. Proc Natl Acad Sci U S A. 1971 Dec;68(12):3223-7. [PMC free article: PMC389626] [PubMed: 4332017]

5.

Gigliotti F, Hendley JO, Morgan J, Michaels R, Dickens M, Lohr J. Efficacy of topical antibiotic therapy in acute conjunctivitis in children. J Pediatr. 1984 Apr;104(4):623-6. [PubMed: 6323667]

6.

Cronin H, Mowad C. Anaphylactic reaction to bacitracin ointment. Cutis. 2009 Mar;83(3):127-9. [PubMed: 19363904]

7.

Sheth VM, Weitzul S. Postoperative topical antimicrobial use. Dermatitis. 2008 Jul-Aug;19(4):181-9. [PubMed: 18674453]

8.

Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006 Apr;24(2):167-97, vi. [PubMed: 16677965]

9.

Murase JE, Heller MM, Butler DC. Safety of dermatologic medications in pregnancy and lactation: Part I. Pregnancy. J Am Acad Dermatol. 2014 Mar;70(3):401.e1-14; quiz 415. [PubMed: 24528911]

10.

Jones RN, Li Q, Kohut B, Biedenbach DJ, Bell J, Turnidge JD. Contemporary antimicrobial activity of triple antibiotic ointment: a multiphased study of recent clinical isolates in the United States and Australia. Diagn Microbiol Infect Dis. 2006 Jan;54(1):63-71. [PubMed: 16368476]

11.

Bonomo RA, Van Zile PS, Li Q, Shermock KM, McCormick WG, Kohut B. Topical triple-antibiotic ointment as a novel therapeutic choice in wound management and infection prevention: a practical perspective. Expert Rev Anti Infect Ther. 2007 Oct;5(5):773-82. [PubMed: 17914912]

12.

Katz BE, Fisher AA. Bacitracin: a unique topical antibiotic sensitizer. J Am Acad Dermatol. 1987 Dec;17(6):1016-24. [PubMed: 2963037]

13.

Saryan JA, Dammin TC, Bouras AE. Anaphylaxis to topical bacitracin zinc ointment. Am J Emerg Med. 1998 Sep;16(5):512-3. [PubMed: 9725969]

14.

Levin HS, Kagan BM. Antimicrobial agents: pediatric dosage, routes of administration and preparation procedures for parenteral therapy. Pediatr Clin North Am. 1968 Feb;15(1):275-90. [PubMed: 4295551]

15.

KOCH R, DONNELL G. Staphylococcic infections in children. Calif Med. 1957 Nov;87(5):313-6. [PMC free article: PMC1512125] [PubMed: 13472470]

16.

Sood A, Taylor JS. Bacitracin: allergen of the year. Am J Contact Dermat. 2003 Mar;14(1):3-4. [PubMed: 14744414]

17.

Spring S, Pratt M, Chaplin A. Contact dermatitis to topical medicaments: a retrospective chart review from the Ottawa Hospital Patch Test Clinic. Dermatitis. 2012 Sep-Oct;23(5):210-3. [PubMed: 23010827]

18.

Zug KA, Warshaw EM, Fowler JF, Maibach HI, Belsito DL, Pratt MD, Sasseville D, Storrs FJ, Taylor JS, Mathias CG, Deleo VA, Rietschel RL, Marks J. Patch-test results of the North American Contact Dermatitis Group 2005-2006. Dermatitis. 2009 May-Jun;20(3):149-60. [PubMed: 19470301]

Sours: https://www.ncbi.nlm.nih.gov/books/NBK536993/

Bacitracin vs. Neosporin: Which Is Better for Me?

Introduction

Cutting your finger, scraping your toe, or burning your arm doesn’t just hurt. These minor injuries can turn into bigger problems if they become infected. You may turn to an over-the-counter (or OTC) product to help. Bacitracin and Neosporin are both OTC topical antibiotics used as first aid to help prevent infection from minor abrasions, wounds, and burns.

These drugs are used in similar ways, but they contain different active ingredients. One product may be better than the other for some people. Compare the major similarities and differences between Bacitracin and Neosporin to decide which antibiotic may be better for you.

Active ingredients and allergies

Bacitracin and Neosporin are both available in ointment forms. Bacitracin is a brand-name drug that contains the active ingredient bacitracin only. Neosporin is the brand name of a combination drug with the active ingredients bacitracin, neomycin, and polymixin b. Other Neosporin products are available, but they contain different active ingredients.

One of the main differences between the two drugs is that some people are allergic to Neosporin but not to Bacitracin. For instance, neomycin, an ingredient in Neosporin, has a higher risk of causing allergic reactions than other ingredients in either drug. Still, Neosporin is safe and works well for most people, like Bacitracin.

It’s especially important with over-the-counter products to read the ingredients. Many of these products may have the same or similar brand names but different active ingredients. If you have questions about the ingredients in an over-the-counter product, it’s better to ask your pharmacist than to guess.

What they do

The active ingredients in both products are antibiotics, so they help prevent infection from minor injuries. These include scratches, cuts, scrapes, and burns to the skin. If your wounds are deep or more severe than minor scratches, cuts, scrapes, and burns, talk to your doctor before using either product.

The antibiotic in Bacitracin stops bacterial growth, while the antibiotics in Neosporin stop bacterial growth and also kill existing bacteria. Neosporin can also fight against a wider range of bacteria than Bacitracin can.

Side effects, interactions, and warnings

Most people tolerate both Bacitracin and Neosporin well, but a small number of people will be allergic to either drug. An allergic reaction can cause a rash or itching. In rare cases, both drugs can cause a more serious allergic reaction. This can cause trouble breathing or swallowing.

Neosporin can cause redness and swelling at the wound site. If you notice this and aren’t sure if it’s an allergic reaction, stop using the product and call your doctor right away. If you think your symptoms are life-threatening, stop using the product and call 911. However, these products don’t typically cause side effects.

Using the ointments

How long you use the product depends on the type of wound you have. You can ask your doctor how long you should use Bacitracin or Neosporin. Do not use either product for longer than seven days unless your doctor tells you to.

You use Bacitracin and Neosporin in the same way. First, clean the affected area of your skin with soap and water. Then, apply a small amount of the product (about the size of the tip of your finger) on the affected area one to three times per day. You should cover the injured area with a light gauze dressing or sterile bandage to keep dirt and germs out.

When to call a doctor

If your wound doesn’t heal after using either drug for seven days, stop using it and contact your doctor. Tell your doctor if your abrasion or burn gets worse or if it cleared up but returned within a few days. Also call your doctor if you:

  • develop a rash or other allergic reaction, such as trouble breathing or swallowing
  • have ringing in your ears or trouble hearing

Key differences

Bacitracin and Neosporin are safe antibiotics for most people’s minor skin wounds. A few key differences may help you choose one over the other.

  • Neomycin, an ingredient in Neosporin, is linked with a higher risk of allergic reactions. Still, any of the ingredients in these products can cause an allergic reaction.
  • Both Neosporin and Bacitracin stop bacterial growth, but Neosporin can also kill existing bacteria.
  • Neosporin can treat more types of bacteria than Bacitracin can.

Talk to your doctor or pharmacist about your individual treatments needs. They can help you choose whether Neomycin or Bacitracin is a better fit for you.

Article sources

  • NEOSPORIN ORIGINAL- bacitracin zinc, neomycin sulfate, and polymyxin b sulfate ointment. (2016, March). Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b6697cce-f370-4f7b-8390-9223a811a005&audience=consumer
  • BACITRACIN- bacitracin zinc ointment. (2011, April). Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=08331ded-5213-4d79-b309-e68fd918d0c6&audience=consumer
  • Wilkinson, J. J. (2015). Headache. In D. L. Krinsky, S. P. Ferreri, B. A. Hemstreet, A. L. Hume, G. D. Newton, C. J. Rollins, & K. J. Tietze, eds. Handbook of Nonprescription Drugs: an Interactive Approach to Self-Care, 18th edition Washington, DC: American Pharmacists Association.
  • National Library of Medicine. (2015, November). Neomycin, polymyxin, and bacitracin topical. Retrieved from https://www.nlm.nih.gov/medlineplus/druginfo/meds/a601098.html
  • National Library of Medicine. (2014, December). Bacitracin topical. Retrieved from https://www.nlm.nih.gov/medlineplus/druginfo/meds/a614052.html
Sours: https://www.healthline.com/health/infection/bacitracin-vs-neosporin
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How does this medication work? What will it do for me?

Polymyxin B sulfate - neomycin sulfate - bacitracin zinc contains a combination of antibiotics used to treat certain types of infections caused by bacteria. The topical ointment can be used to treat certain skin infections and to prevent infections in burns, minor cuts, and wounds. This preparation works by killing the bacteria that cause these infections.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each gram contains polymyxin B sulfate 5,000 IU (international units), bacitracin zinc 400 IU, and neomycin sulfate 5 mg, in a low melting point petrolatum base.

How should I use this medication?

After removing any debris, such as pus or crusts, from the affected area, apply a thin layer of the ointment 2 to 5 times daily over the affected area. You may cover the area with dressing or leave it exposed. Do not use the ointment in the eyes.

This medication should not be used for more than 7 days without medical supervision. If there is no improvement after 7 days of using this medication, call your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, apply it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to polymyxin B sulfate, neomycin sulfate, bacitracin zinc, or any ingredients of this medication
  • are allergic to medications belonging to the class of medications known as aminoglycosides (e.g., gentamicin)
  • have an external ear infection when there is a perforated eardrum
  • have eye infections (this medication is not for the eye)
  • have nerve deafness
  • may need this treatment for a long period of time or have a very large affected area, where a significant amount of medication may be absorbed into the body

Do not give this medication to children younger than 2 years of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • itching, pain, skin rash, scaling, swelling, redness, or other signs of skin irritation not present before use of this medication

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blood in urine
  • difficulty with urination
  • loss of hearing
  • weakness, tingling, or numbness in hands or feet

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a severe allergic reaction such as severe rash or hives; difficulty breathing; or swelling of the mouth, lips, tongue, or throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Absorption: Absorbing a large amount of this medication into the body can increase the risk of damage to the ears or kidneys due to neomycin. Your doctor will monitor your closely if you are using this medication for burns, large ulcers, and other extensive conditions where significant absorption of neomycin is possible.

Allergies: Some people with certain skin conditions like eczema, ulcers, or chronic swimmer's ear may be more likely to develop an allergy to the ingredients of this medication. If your skin becomes scaly, red, swollen, or itchy, you should stop taking the medication and call your doctor as soon as possible.

Kidney function: People with decreased kidney function may need to use a lower dose. Your doctor will monitor you if you have decreased kidney function and are using this medication.

Overgrowth of organisms: Prolonged use of this medication may cause an overgrowth of types of organisms that this medication does not effectively kill. If the affected area worsens or does not improve, call your doctor as soon as possible.

Pregnancy: This medication is not recommended for use during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. This medication is not recommended for use while breast-feeding.

Children: For newborns and infants, absorption by immature skin may be increased. Very young children who use this medication may be at risk of increased blood levels and side effects. This medication is not recommended for children under 2 years of age.

Seniors: A decrease in dose may be necessary in seniors with decreased kidney function or a likelihood to absorb a significant amount of medication.

What other drugs could interact with this medication?

There may be an interaction between this medication and any of the following:

  • aminoglycoside antibiotics (e.g., gentamicin, tobramycin)
  • neuromuscular blocking agents (e.g., pancuronium, rocuronium)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Neosporin-Ointment

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Bacitracin Pharmacology and Mechanism of Action

Bacitracin Topical

pronounced as (bass i tray' sin)

Bacitracin is used to help prevent minor skin injuries such as cuts, scrapes, and burns from becoming infected. Bacitracin is in a class of medications called antibiotics. Bacitracin works by stopping the growth of bacteria.

Bacitracin comes as an ointment to apply to the skin. It is usually used one to three times a day. Bacitracin ointment is available without a prescription. However, your doctor may give you special directions on the use of this medication for your medical problem. Follow the directions on the package or those given to you by your doctor carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use bacitracin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor or written on the package.

This medication is for use only on the skin. Do not let bacitracin get into your eyes, nose, or mouth and do not swallow it.

You may use bacitracin to treat minor skin injuries. However, you should not use this medication to treat deep cuts, puncture wounds, animal bites, serious burns, or any injuries that affect large areas of your body. You should call your doctor or get emergency medical help if you have these types of injuries. A different treatment may be needed. You should also stop using this medication and call your doctor if you use this medication to treat a minor skin injury and your symptoms do not go away within 1 week.

Do not apply this medication to a child's diaper area, especially if the skin surface is broken or raw, unless told to do so by a doctor. If you are told to apply it to a child's diaper area, do not use tightly fitting diapers or plastic pants.

To use the ointment, follow these steps:

  1. Wash your hands well with soap and water. Wash the injured area with soap and water and pat dry thoroughly with a clean towel.
  2. Apply a small amount of the ointment (an amount equal to the size of your finger tip) to the injured skin. A thin layer is all that is needed. Do not touch the tip of the tube to your skin, hands, or anything else.
  3. Replace and tighten the cap right away.
  4. You may cover the affected area with a sterile bandage.
  5. Wash your hands again.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using bacitracin,

  • tell your doctor and pharmacist if you are allergic to bacitracin, zinc, any other medications, or any of the ingredients in bacitracin ointment.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using bacitracin, call your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

If your doctor has told you to use this medication, keep all appointments with your doctor. Call your doctor if you still have symptoms of infection after you finish using this medication as directed.

Ask your pharmacist any questions you have about bacitracin ointment.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Last Revised - 03/15/2017

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Ointment prescription bacitracin

bacitracin, neomycin, and polymyxin B (topical)

What is the most important information I should know about this medicine?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is bacitracin, neomycin, and polymyxin B?

Bacitracin, neomycin, and polymyxin B are antibiotics that kill bacteria on your skin.

Bacitracin, neomycin, and polymyxin B topical (for the skin) is a combination medicine used as a first aid antibiotic to prevent infections in minor cuts, scrapes, or burns on your skin.

Bacitracin, neomycin, and polymyxin B topical may also be used for other purposes not listed in this medication guide.

What should I discuss with my health care provider before using this medicine?

You should not use this medication if you are allergic to bacitracin, neomycin, or polymyxin B.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have other medical conditions, especially:

  • chronic ear infections; or
  • a ruptured (torn) eardrum.

It is not known whether bacitracin, neomycin, and polymyxin B topical will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether bacitracin, neomycin, and polymyxin B topical passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Bacitracin, neomycin, and polymyxin B topical should not be used on a child younger than 2 years old without medical advice.

How should I use this medicine?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Before you apply this medication, wash the skin area with soap and water and then dry it thoroughly.

Do not apply the ointment over large skin areas. Do not use on a deep cut, an animal bite, or a serious burn. Contact your doctor for instructions on how to treat these more severe skin injuries.

This medication can be applied up to 3 times each day, or as directed on the medicine label. Cover the wound with a bandage if desired. Clean the wound and use a new bandage each time you apply the medicine.

Use the ointment for as many days as recommended on the label or by your doctor, even if your symptoms start getting better. Your symptoms may improve before the infection is completely cleared.

Call your doctor if your symptoms do not improve after 7 days of treatment, or if they get worse while using bacitracin, neomycin, and polymyxin B topical.

Store at room temperature away from moisture and heat. Throw away any ointment not used before the expiration date on the medicine label.

What happens if I miss a dose?

Apply the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

An overdose of bacitracin, neomycin, and polymyxin B topical is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

What should I avoid while using this medicine?

Do not take by mouth. Bacitracin, neomycin, and polymyxin B topical is for use only on your skin. Avoid getting this medicine in your eyes, nose, or mouth. If this does happen, rinse with water.

Avoid applying other creams, lotions, ointments, or other medicated skin products to the same areas you treat with bacitracin, neomycin, and polymyxin B.

What other drugs will affect bacitracin, neomycin, and polymyxin B?

It is not likely that other drugs you take orally or inject will have an effect on topically applied bacitracin, neomycin, and polymyxin B. But many drugs can interact with each other. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Where can I get more information?

Your pharmacist can provide more information about bacitracin, neomycin, and polymyxin B topical.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2021 Cerner Multum, Inc. Version: 2.01. Revision date: 9/23/2013.

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