Topical Antibiotic Pregnancy: C

Bacitracin Zinc (Topical Antibiotic)

Brand names: Polyfax (bacitracin + polymyxin B), Cicatrin

Adult dose

Dose: Apply thin layer to affected area 1–3 times daily; cover with sterile dressing if needed

Route: topical

Frequency: once to three times daily

Max: Topical use only

Not absorbed systemically; effective against Gram-positive organisms; Polyfax covers both Gram-positive (bacitracin) and Gram-negative (polymyxin B)

Route: topical

Frequency: once to three times daily

Concentration: Ointment: 500 units/g bacitracin + 10,000 units/g polymyxin B /ml

Safe in all ages topically; avoid large surface area in premature infants (systemic absorption risk)

Renal

Not applicable (topical use)

Hepatic

Not applicable

Bacitracin systemic use: nephrotoxic — topical use ONLY in UK practice
Polyfax ointment: useful for small infected burns, infected wounds, and skin graft donor sites
Resistance is rare for bacitracin in Staphylococcus — maintains efficacy for superficial infections

Systemic use (nephrotoxic)
Hypersensitivity to bacitracin
Known aminoglycoside allergy (cross-reactivity with neomycin-containing products)

Reference: BNFc; BNF 86; Burns wound care guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

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