Generality
Bacitracin is an active ingredient belonging to the group of polypeptide antibiotics .
More in detail, bacitracin is used in association with other active ingredients in the treatment of intestinal infections (oral administration) and in the treatment of skin infections (topical administration).
The medicinal products based on bacitracin suitable for oral administration (tablets), in order to be dispensed, require presentation of a repeatable medical prescription . On the contrary, topical medicines based on bacitracin (skin cream and powder) are over -the-counter (OTC) drugs, therefore, their free sale is allowed.
Examples of Specialties Medicines containing Bacitracin
- Bimixin® (oral administration)
- Cicatrene® (topical administration)
- Orobicin® (oral administration)
Therapeutic indications
When is the use of Bacitracin indicated?
As mentioned, bacitracin is used in combination with other active ingredients - antibiotics and non-antibiotics - to treat infections of the intestine and skin .
Bacitracin by mouth
Bacitracin-based oral medicines also contain another active ingredient with antibiotic action - neomycin - and are indicated in the following cases:
- Treatment of intestinal infections sustained by bacteria sensitive to bacitracin and neomycin;
- Preventive treatment in preparation for colon surgery .
Bacitracin topically
Topical medicines based on bacitracin also contain other active ingredients with antibiotic action ( neomycin ) and active ingredients capable of stimulating tissue healing ( amino acids ) and are indicated for the treatment of superficial skin infections, minor burns and wounds infected .
Did you know that ...
Bacitracin is an active ingredient also included in the composition of veterinary medicines (Bacivet S®), the use of which is indicated to reduce the symptoms and mortality caused by enzootic enterocolitis induced by infections sustained by Clostridium perfringens sensitive to bacitracin.
Warnings
Warnings and Precautions for the use of Bacitracin
Before using bacitracin-based medicines for both oral and topical use, you must inform your doctor if you are in one or more of the following conditions:
- You are allergic to aminoglycoside antibiotics;
- You are suffering from disorders or diseases of the liver (in particular, as regards the oral administration of bacitracin);
- You suffer from kidney failure;
- You are taking other medicines that can adversely affect your kidney and ear (nephrotoxicity and ototoxicity).
However, as a precautionary measure, before taking bacitracin-based medicines, it is always advisable to inform your doctor of your health conditions, informing you of the possible presence of any type of disorder or illness, even if not present in the above reported bulleted list.
Pharmacological Interactions
Interactions between Bacitracin and Other Drugs
Because of the drug interactions that could occur, before starting bacitracin treatment, you need to tell your doctor if you are taking - or have recently been taken - one or more of the following drugs:
- Anticoagulant drugs;
- Neuromuscular blockers ;
- Antiemetics ;
- Drugs for the treatment of motion sickness ;
- Diuretics ;
- Other drugs that can exert nephrotoxic or ototoxic action .
Furthermore, before using bacitracin- based medicines for topical use, it is advisable to inform your doctor if you are using, or have recently used, aminoglycoside antibiotic drugs .
In any case, before starting bacitracin therapy - be it by mouth or topically - it is necessary to tell the doctor if you are taking, or have recently been taken, drugs or products of any kind, including medicines without a medical prescription (SOP), over-the-counter drugs (OTC), herbal and phytotherapeutic products and homeopathic products.
Side effects
Side effects caused by the intake of Bacitracin
Like any other active ingredient, even after the administration of bacitracin it is possible that side effects may develop, even if not all patients manifest them, or manifest them in the same way. In fact, each person reacts in a subjective manner to the administration - oral or topical - of bacitracin, manifesting side effects that are different in type and / or intensity, or not at all.
Bacitracin by mouth
Following the oral intake of bacitracin - used for the treatment of intestinal infections or for the preparation for colon surgery - the following side effects could occur:
- Nausea and / or vomiting;
- Constipation;
- Malabsorption syndrome with diarrhea and steatorrhea (a side effect that tends to occur especially in the case of prolonged therapies);
- Urination disorders and phenomena of nephrotoxicity that can occur with the appearance of:
- oliguria;
- hematuria;
- albuminuria;
- Increased blood urea;
- cylindruria;
- Etc.
- Ototoxicity that can manifest itself with the appearance of:
- Hearing loss;
- Buzzing perception;
- Dizziness;
- Etc.
- Allergic reactions in sensitive individuals.
Bacitracin topically
During topical use of bacitracin for the treatment of skin infections, wounds and small burns, the following side effects may arise:
- Itch;
- Redness;
- superinfections;
- Allergic reactions, even serious, in sensitive individuals.
Overdose
Bacitracin for oral use
In case of oral intake of very high doses of bacitracin it is possible that:
- ototoxicity;
- nephrotoxicity;
- Malabsorption with diarrhea and steatorrhea.
Therefore, in the case of an overdose of bacitracin orally - ascertained or presumed to be - it is advisable to contact the doctor immediately or contact the nearest emergency department, taking care to bring along the packaging of the medicinal product taken.
Bacitracin for topical use
Bacitracin overdose when it is applied locally to the skin is a rare event, unless occlusive bandages are used. For this reason, the latter should never be used when using topical bacitracin-based medicines.
Method of use and Posology
How to take Bacitracin
For oral intake, bacitracin is available as tablets that should be swallowed whole, possibly with the help of a little water. The dosage of bacitracin to be administered orally should be established by the doctor for each patient. However, the doses usually used in therapy are as follows:
- Adults : 2, 500-5, 000 IU of bacitracin every 6-8 hours (usually one tablet contains 2, 500 IU of active ingredient);
- Children over the age of two years : 2, 500 IU bacitracin every 6-8 hours.
The duration of treatment should not exceed 3-5 days.
For topical use, on the other hand, bacitracin is available in the form of skin cream and powder that must be applied locally directly to the area of the skin affected by the infection, from the wound or from the burn. Usually, it is recommended to make two applications per day, avoiding occlusive bandages .
Action mechanism
How does Bacitracin work?
Bacitracin is a polypeptide antibiotic obtained from strains of Bacillus subtilis sporigeni (Gram-positive bacteria). It is therefore an active ingredient of natural origin . Bacitracin has both bacteriostatic and bactericidal activity against:
- Several Gram-positive microorganisms;
- Some Gram-negative bacteria (including some Salmonella strains - excluding S. typhi - and Klebsiella );
- Some microorganisms belonging to the group of clostridia .
The mechanism of action by which bacitracin is able to carry out its bacteriostatic and bactericidal activities is similar to that of penicillins and involves the inhibition of bacterial cell wall synthesis . More in detail, bacitracin appears to be able to interfere with the dephosphorylation of C55-isoprenyl pyrophosphate (bactoprenol pyrophosphate), one of the fundamental elements for the construction of the bacterial peptidoglycan.
Pregnancy and breastfeeding
Can Bacitracin be taken during pregnancy and during breastfeeding?
The use of bacitracin during pregnancy and lactation, both orally and topically, should only take place if strictly necessary and only under a doctor's recommendation and control .
Therefore, pregnant women and breastfeeding mothers must inform their doctor of their condition before taking bacitracin in any form.
Contraindications
When Bacitracin should not be used
Regardless of the pharmaceutical form and route of administration used, the use of bacitracin is contraindicated in the case of:
- Known hypersensitivity to bacitracin itself, to other active ingredients and / or to one or more of the excipients contained in the medicinal product to be used.
Oral bacitracin is also contraindicated in children under the age of 2 years and in the presence of:
- Kidney failure;
- Intestinal blockage, even if partial;
- malabsorption;
- Myasthenic syndromes;
- Concomitant intake of nephrotoxic medicinal products (eg, streptomycin, kanamycin, gentamicin, polymyxin, cephalosporins, etc.).
The use of bacitracin topically, on the other hand, is contraindicated in infants, in premature babies and also in the case in which:
- The infection, the burn or the wound to be treated are located near the eyes;
- The infection is located in the ear canal and there is perforation of the eardrum.
