bacitracin
Regulatory sources consulted
Approved indications
- First aid to help prevent infection in minor cuts, scrapes, and burns, as a triple-antibiotic combination.
Contraindications
Absolute
- Do not use if allergic to any ingredient in the combination: bacitracin zinc, neomycin sulfate, or polymyxin B sulfate.
Clinical warnings
- For external use only. The regimen and indication apply to the bacitracin-neomycin-polymyxin B combination, not to the isolated ingredient. — openFDA Triple Antibiotic ointment set ID 0070ea5f-434d-53a7-e063-6294a90abf18
- Major warning · Do not use in the eyes, over large areas, or for longer than 1 week unless directed by a doctor. Ask a doctor before use on deep or puncture wounds, animal bites, or serious burns. Stop and seek advice if the condition worsens or persists, or if a rash or allergic reaction develops. — openFDA Triple Antibiotic ointment set ID 0070ea5f-434d-53a7-e063-6294a90abf18
Pregnancy and lactation
No specific recommendation is established for pregnancy or breastfeeding.
Recent literature (PubMed)
Clinical management of Staphylococcus aureus infections presents a challenge due to the high incidence, considerable virulence, and emergence of drug resistance mechanisms. The treatment of drug-resistant strains, such as methicillin-resistant S. aureus (MRSA), is further complicated by the development of tolerance and persistence to antimicrobial agents in clinical use. To address these challenges, membrane disruptors, that are not generally considered during drug discovery for agents against S. aureus, should be explored. The cell membrane protects S. aureus from external stresses and antimicrobial agents, but membrane-targeting antimicrobial agents are probably less likely to promote bacterial resistance. Nontypical linear cationic antimicrobial peptides (AMPs), highly modified AMPs such as daptomycin (lipopeptide), bacitracin (cyclic peptide), and gramicidin S (cyclic peptide), are currently in clinical use. Recent studies have demonstrated that AMPs and small molecules can penetrate the cell membrane of S. aureus, inhibit phospholipid biosynthesis, or block the passage of solutes between the periplasm and the exterior of the cell. In addition to their primary mechanism of action (MOA) that targets the bacterial membrane, AMPs and small molecules may also impact bacteria through secondary mechanisms such as targeting the biofilm, and downregulating virulence genes of S. aureus. In this review, we discuss the current state of research into cell membrane-targeting AMPs and small molecules and their potential mechanisms of action against drug-resistant physiological forms of S. aureus, including persister cells and biofilms.
Current guidance suggests oral antibiotics can be considered for children with acute otitis media (AOM) and ear discharge, but there is an absence of evidence regarding the relative effectiveness of antibiotic-corticosteroid eardrops. To establish whether antibiotic-corticosteroid eardrops are non-inferior to oral antibiotics in children with AOM and ear discharge. Open randomized controlled non-inferiority trial set in Dutch primary care. Children were randomized to hydrocortisone-bacitracin-colistin eardrops (five drops, three times per day in the discharging ear(s)) or amoxicillin suspension (50 mg per kilogram of body weight per day, divided over three doses administered orally) for 7 days. The primary outcome was the proportion of children with resolution of ear pain and fever at day 3. Between December 2017 and March 2023, 58 of the planned 350 children were recruited due to slow accrual for various reasons. Children assigned to eardrops (n = 26) had lower resolution rates of ear pain and fever at 3 days compared to those receiving oral antibiotics (n = 31): 42% vs 65%; adjusted risk difference 20.3%, 95% confidence interval -5.3% to 41.9%), longer parent-reported ear discharge (6 vs 3 days; P = .04), and slightly higher mean ear pain scores (Likert scale 0-6) over days 1-3 (2.1 vs 1.4, P = .02), but received fewer oral antibiotic courses in 3months (11 for 25 children vs 33 for 30 children), and had less GI upset and rash (12% vs 32% and 8% vs 16%, respectively). Early termination stopped us from determining non-inferiority of antibiotic-corticosteroid eardrops. Our limited data, requiring confirmation, suggest that oral antibiotics may be more effective than antibiotic-corticosteroid eardrops in resolving symptoms and shortening the duration of ear discharge.
The entity "contact pemphigus" has been recognized for more than 50 years, however existence of the disease, which is opposed and supported by many, is questionable. Contact pemphigus is defined as pemphigus occurring at the site of local skin contact with different chemicals. Many products have been disclosed as aetiological factors such as pesticides, topical drugs (imiquimod, ketoprofen, phenol, bezoin, polymyxin B sulphate, neomycin and bacitracin), cosmetics, garlic and others. This paper summarizes the current knowledge on contact pemphigus and the chemicals responsible for its aetiology, with an emphasis on mechanisms that may elicit the disease.
Streptococcus pneumoniae is a highly adept human pathogen. A frequent asymptomatic member of the respiratory microbiota, the pneumococcus has a remarkable capacity to cause mucosal (pneumonia and otitis media) and invasive diseases (bacteremia, meningitis). In addition, the organism utilizes a vast battery of virulence factors for tissue and immune evasion. Though recognized as a significant cause of pneumonia for over a century, efforts to develop more effective vaccines remain ongoing. The pathogen's inherent capacity to exchange genetic material is critical to the pneumococcus' success. This feature historically facilitated essential discoveries in genetics and is vital for disseminating antibiotic resistance and vaccine evasion.