Bacitracin and polymyxin B

MEDICATION SAFETY ISSUES
Sound-alike/look-alike issues:

Betadine® may be confused with Betagan®, betaine

U.S. BRAND NAMES — AK-Poly-Bac™ ; Polysporin® [OTC]

PHARMACOLOGIC CATEGORY
Antibiotic, Ophthalmic
Antibiotic, Topical

DOSING: ADULTS
Ophthalmic infection: Ophthalmic (ointment): Instill 1/2" ribbon in the affected eye(s) every 3-4 hours for acute infections or 2-3 times/day for mild-to-moderate infections for 7-10 days.

Superficial dermal infection: Topical ointment/powder: Apply to affected area 1-4 times/day; may cover with sterile bandage if needed.

DOSING: PEDIATRIC — Refer to adult dosing.

(For additional information see "Bacitracin and polymyxin B: Pediatric drug information")

DOSING: ELDERLY — Refer to adult dosing.

DOSAGE FORMS — Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, ophthalmic: Bacitracin 500 units and polymyxin B 10,000 units per g (3.5 g)
AK-Poly-Bac™ : Bacitracin 500 units and polymyxin 10,000 units per g (3.5 g)

Ointment, topical: Bacitracin 500 units and polymyxin B 10,000 units per g in white petrolatum (15 g, 30 g)
Polysporin®: Bacitracin 500 units and polymyxin B 10,000 units per g (0.9 g, 15 g, 30 g)

Powder, topical:
Polysporin®: Bacitracin 500 units and polymyxin B 10,000 units per g (10 g)

DOSAGE FORMS: CONCISE
Ointment, ophthalmic: Bacitracin 500 units and polymyxin B 10,000 units per g (3.5 g)
AK-Poly-Bac™ : Bacitracin 500 units and polymyxin 10,000 units per g (3.5 g)

Ointment, topical: Bacitracin 500 units and polymyxin B 10,000 units per g in white petrolatum (15 g, 30 g)
Polysporin®: Bacitracin 500 units and polymyxin B 10,000 units per g (0.9 g, 15 g, 30 g)

Powder, topical:
Polysporin®: Bacitracin 500 units and polymyxin B 10,000 units per g (10 g)

GENERIC EQUIVALENT AVAILABLE — Yes

USE — Treatment of superficial infections caused by susceptible organisms

ADVERSE REACTIONS SIGNIFICANT — 1% to 10%: Local: Rash, itching, burning, anaphylactoid reactions, swelling, conjunctival erythema

CONTRAINDICATIONS — Hypersensitivity to bacitracin, polymyxin B, or any component of the formulation

DRUG INTERACTIONS
Capreomycin: May enhance the neuromuscular-blocking effect of Polymyxin B. Risk C: Monitor therapy

Colistimethate: Polymyxin B may enhance the neuromuscular-blocking effect of Colistimethate. Risk C: Monitor therapy

Neuromuscular-Blocking Agents: Polymyxin B may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Risk D: Consider therapy modification

PREGNANCY RISK FACTOR — C (show table)

PREGNANCY IMPLICATIONS — Animal reproduction studies have not been conducted with this combination; therefore, Bacitracin and Polymyxin B is considered pregnancy category C. See individual agents.

LACTATION — Excretion in breast milk unknown/use caution

BREAST-FEEDING CONSIDERATIONS — It is not known if bacitracin or polymyxin B is found in breast milk. The manufacturer recommends that caution be exercised when administering Bacitracin and Polymyxin B to nursing women. See individual agents.

PRICING — (data from drugstore.com)
Ointment (Bacitracin-Polymyxin B)
500-10000 units/g (3.5): $17.99

CANADIAN BRAND NAMES — LID-Pack®; Optimyxin®

INTERNATIONAL BRAND NAMES — Glubacida (MX); Miratracina (CO); Nebacetina (MX); Neobacitracine (BE); Neospor & iacute;n Dermico (MX); Polisulfade (PT); Polixin Ungena (MX); Polyfax (MY); Polysporin Ophthalmic (ZA); Tribiot (MX)

MECHANISM OF ACTION — See individual agents.

PHARMACODYNAMICS / KINETICS — See individual agents.