Skip to content
Dr. Grey AI

Peptide

Bacitracin

Bacitracin is a cyclic polypeptide antibiotic from Bacillus licheniformis, FDA-approved 1948. Primarily TOPICAL use for gram-positive skin infections. Combination products (triple antibiotic with neomycin/polymyxin B) are OTC first-aid kit staples. B-GRADE evidence: Cardiac surgery review (n=1495) showed zero deep sternal wound infections with prophylactic use. SAFETY: Systemic use ABANDONED due to severe nephrotoxicity. Topical is safe but allergic contact dermatitis occurs in 7-9% with prolonged exposure. One of the oldest antibiotics still in widespread use.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
3
Outcomes
7
Graded outcomes
1411

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

3 conditions, plus general outcomes

Kidney Health

Kidney Health: outcomes studied for Bacitracin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Systemic Nephrotoxicity

SAFETY CONCERN: Systemic administration causes severe nephrotoxicity - reason for topical-only use restriction. Parenteral use abandoned. Excreted 87% renally within 6 hours. Topical absorption negligible.

Worsens (the measure goes up)Large effect4 studies

Studies that measured systemic nephrotoxicity

Skin Health

Skin Health: outcomes studied for Bacitracin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Wound Infection Prevention

Systematic review and meta-analysis of 12 trials: Topical antibiotics reduce wound infections vs placebo. Cardiac surgery (n=1495): Zero deep sternal wound infections with routine bacitracin. Widely used for minor cuts, scrapes, burns.

Improves (the measure goes up)Moderate effect9 studies

Studies that measured wound infection prevention

Sternal Wound Prophylaxis

Retrospective review (n=1495 cardiac surgeries): Routine topical bacitracin on incision associated with absence of deep sternal wound infections. Safe and inexpensive adjunct strategy.

Improves (the measure goes up)Large effect9 studies

Studies that measured sternal wound prophylaxis

Allergic Contact Dermatitis

SAFETY CONCERN: Allergic contact dermatitis in 7.7-9.2% with prolonged use. Delayed hypersensitivity may not appear until 96 hours. Rare anaphylactic reactions reported. Patch test before extended use.

Worsens (the measure goes up)Small effect4 studies

Studies that measured allergic contact dermatitis

Eye Health

  • Ophthalmic Infections: improves
Eye Health: outcomes studied for Bacitracin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Ophthalmic Infections

FDA-approved ophthalmic formulation for bacterial conjunctivitis and eye infections. Often combined with polymyxin B. Standard therapy for bacterial eye infections.

Improves (the measure goes up)Moderate effect6 studies

Studies that measured ophthalmic infections

General

  • Antimicrobial Activity: improves
  • Kidney Function: improves
General: outcomes studied for Bacitracin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Antimicrobial Activity

3 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies

Studies that measured antimicrobial activity

Kidney Function

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect3 studies

Studies that measured kidney function

Key findings

  • Systemic NephrotoxicityKidney HealthWorsens (the measure goes up)
  • Wound Infection PreventionSkin HealthImproves (the measure goes up)
  • Sternal Wound ProphylaxisSkin HealthImproves (the measure goes up)

Studies cited

14 studies from PubMed

  1. A classic antibiotic reimagined: Rationally designed bacitracin variants exhibit potent activity against vancomycin-resistant pathogensACS Infect Dis, 2024 · PMID 38990944
  2. Routine Use of Topical Bacitracin to Prevent Sternal Wound Infections After Cardiac SurgeryInnovations (Phila), 2017 · PMID 28709667
  3. Complications associated with bacitracin powder in surgical woundsJ Neurosurg Pediatr, 2015 · PMID 26382180
  4. Topical triple-antibiotic ointment as a novel therapeutic choice in wound management and infection prevention: a practical perspectiveJ Clin Aesthet Dermatol, 2007 · PMID 17914912
  5. Metal binding and structure-activity relationship of the metalloantibiotic peptide bacitracin.Journal of inorganic biochemistry, 2002 · PMID 12121761
  6. Topical antimicrobial prophylaxis in minor woundsAnn Pharmacother, 1997 · PMID 9161648
  7. Chemotherapy for giardiasis: randomized clinical trial of bacitracin, bacitracin zinc, and a combination of bacitracin zinc with neomycin.The American journal of tropical medicine and hygiene, 1995 · PMID 7741168
  8. Comparison of topical antibiotic ointments, a wound protectant, and antiseptics for the treatment of human blister wounds contaminated with Staphylococcus aureusJ Fam Pract, 1993 · PMID 3585263
  9. Dissociation of the antimicrobial activity of bacitracin USP from its renovascular effects.Antimicrobial agents and chemotherapy, 1992 · PMID 1510419
  10. Bacitracin: a unique topical antibiotic sensitizerAm J Contact Dermat, 1987 · PMID 2963037
  11. Mechanism of action of bacitracin: complexation with metal ion and C55-isoprenyl pyrophosphateProc Natl Acad Sci USA, 1971 · PMID 4332017
  12. Bacitracin nephropathy: report of a case of acute renal failure and death.Journal of the American Medical Association, 1954 · PMID 13162821
  13. The effect of bacitracin on renal function.The Journal of clinical investigation, 1950 · PMID 15415438
  14. BACITRACIN; new effective antibiotic agent.American professional pharmacist, 1945 · PMID 21005077