bacitracin

[BACI(LLUS) + Margaret Tracy, an American child in whose blood it was first isolated + -IN.]

An antibiotic produced by a gram-positive, spore-forming organism of the Bacillus licheniformis group; usually administered topically.

Brand names: AK-Tracin®Baci-IM®Baci-RX®Baciguent®Ocu-Tracin®

Chemical formula:

Drug Forms:
• Bacitracin Zinc Topical ointment (below)
• Bacitracin Ophthalmic ointment
• Bacitracin Solution for injection
• Bacitracin Topical ointment

Español:
• Bacitracina Cinc, Pomada tópica
• Bacitracina, Pomada oftálmica
• Bacitracina, Solución para inyección
• Bacitracina, Pomada tópica

Bacitracin Zinc Topical ointment

What is this medicine?

BACITRACIN (bass i TRAY sin) is a polypeptide antibiotic. It is used to treat bacterial skin infections or to prevent infection of minor burns, cuts, or scrapes.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•animal bites
•large areas of damaged skin
•puncture wound
•severe burns
•an unusual or allergic reaction to bacitracin, neomycin, other antibiotics, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

This medicine is only for external use on the skin. Follow the directions on the prescription label. Wash hands before and after use. Apply a thin layer to cover the affected area. You can cover the treated area with a sterile gauze dressing (bandage). Use this medicine at regular intervals. Do not use more often than directed. Finish the full course prescribed by your doctor or health care professional even if you think you are better. Do not stop using except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

What may interact with this medicine?

Interactions are not expected. Do not use other skin care products unless your doctor or health care professional tells you to.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or health care professional if the infection does not get better within 1 week or if they get worse.

Do not get this medicine in your eyes. If you do, rinse out with plenty of cool tap water.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•breathing problems
•chest tightness
•lower back pain
•pain, difficulty passing urine

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•skin irritation

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

An antibacterial substance elaborated by the licheniformis group of Bacillus subtilis, found in a contaminated wound, and named after the patient, Margaret Tracy; useful in a wide range of infections and usually applied topically.

Bacitracin
Systematic (IUPAC) name
(4R)-4-[(2S)-2-({2-[(1S)-1-amino-2-methylbutyl]- 4,5-dihydro-1,3-thiazol-5-yl}formamido)-4-methylpentanamido]-4-{[(1S)- 1-{[(3S,6R,9S,12R,15S,18R,21S)- 18-(3-aminopropyl)-12-benzyl-15-(butan-2-yl)-3-(carbamoylmethyl)- 6-(carboxymethyl)-9-(1H-imidazol-5-ylmethyl)-2,5,8,11,14,17,20- heptaoxo-1,4,7,10,13,16,19-heptaazacyclopentacosan-21-yl]carbamoyl}- 2-methylbutyl]carbamoyl}butanoic acid
Identifiers
CAS number	1405-87-4
ATC code	D06AX05 R02AB04 QA07AA93
PubChem	439542
DrugBank	APRD00816
ChemSpider	10481985
Chemical data
Formula	C66H103N17O16S
Mol. mass	1422.69 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	?
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status	OTC/℞-only
Routes	Topical, intramuscular
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A tube of bacitracin ointment for eyes

Bacitracin is a mixture of related cyclic polypeptides produced by organisms of the licheniformis group of Bacillus subtilis var Tracy, isolation of which was first reported in 1945.

As a toxic and difficult-to-use antibiotic, bacitracin doesn't work well orally. However, it is very effective topically. Its action is on gram positive cell walls.

Contents 1 History 2 Synthesis 3 Mechanism of action 4 Clinical use 5 References

History

The drug's unique name derives from the fact that it was isolated by John T. Goorley from a girl named Tracy:

One strain isolated from tissue debrided from a compound fracture of the tibia was particularly active. We named this growth-antagonistic strain for the patient, "Tracy I." When cell-free filtrates of broth cultures of this bacillus proved to possess strong antibiotic activity and to be non-toxic, further study seemed warranted. We have called this active principle "Bacitracin."^[1]

It was approved by FDA in 1948.

Synthesis

Bacitracin is synthesised via the so-called nonribosomal peptide synthetases (NRPSs), which means that ribosomes are not involved in its synthesis.

bacABC is involved in synthesis.^[2]

Mechanism of action

Main article: Bactoprenol phosphate

Bacitracin interferes with the dephosphorylation of the C₅₅-isoprenyl pyrophosphate, a molecule which carries the building blocks of the peptidoglycan bacterial cell wall outside of the inner membrane ^[3].

Bacitracin is a protein disulfide isomerase inhibitor.^[4]

Clinical use

Bacitracin is used in human medicine as a polypeptide antibiotic and is "approved by the U.S. Food and Drug Administration (FDA) for use in chickens and turkeys."^[5]

As bacitracin zinc salt, and in combination with other topical antibiotics (usually polymyxin B and neomycin), it is used in ointment form for topical treatment of a variety of localized skin and eye infections, as well as for the prevention of wound infections. In the United States a popular brand name Neosporin contains Bacitracin as one of its antibiotic agents along with Neomycin and Polymyxin B. Bacitracin can also be bought in pure form for those with allergies.

It is also commonly used as an aftercare antibiotic on tattoos. It is preferred over Neosporin because of its fewer ingredients, which lowers chances of an allergic reaction.^[6]

In infants, it is sometimes administered intramuscularly for the treatment of pneumonias,but in most cases, it has been replaced by other antibiotics. This formulation is sold under the brand name Baciim.

Clinical note: This is a good alternative to silver sulfadiazine (Silvadene) for burn patients with a sulfa allergy.

Bacitracin can be used to distinguish Streptococcus pyogenes from Streptococcus agalactiae,^[7] with S. pyogenes being sensitive and S. agalactiae being resistant to bacitracin.

It was voted Allergen of the Year in 2003 by the American Contact Dermatitis Society.

References

1. ^ Johnson B, Anker H, Meleney F (1945). "Bacitracin: a new antibiotic produced by a member of the B. subtilis group".Science 102 (2650): 376–377.
2. ^ Murphy, T.; Roy, I.; Harrop, A.; Dixon, K.; Keshavarz, T. (2007). "Effect of oligosaccharide elicitors on bacitracin a production and evidence of transcriptional level control". Journal of biotechnology 131 (4): 397–403. doi:10.1016/j.jbiotec.2007.07.943. PMID 17825450.  edit
3. ^ Mechanism of Action of Bacitracin: Complexation with Metal Ion and C55-Isoprenyl Pyrophosphate K. John Stone and Jack L. Strominger
4. ^ Weston, B.; Wahab, N.; Roberts, T.; Mason, R. (2001). "Bacitracin inhibits fibronectin matrix assembly by mesangial cells in high glucose". Kidney international 60 (5): 1756–1764. doi:10.1046/j.1523-1755.2001.00991.x. PMID 11703593.  edit
5. ^ Antibiotic use on the farm hurts people—and doesn’t help the bottom line. Discover Magazine. Accessed on September 16, 2007.
6. ^ Tattoo Aftercare Contradictions
7. ^ "Streptococci". http://pathmicro.med.sc.edu/fox/streptococci.htm. Retrieved 2008-11-07. 

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