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  • A 4-year-old boy is brought to the urgent care clinic after falling during school recess. He scraped his right knee on the gravel resulting in a wound. He has no medical issues and his vaccinations are up to date. On exam, he is crying from the pain. After cleaning the wound, an ointment is applied to prevent a bacterial infection.  
Introduction
  • Drugs
    • bacitracin
      • topical
      • intramuscular injection in pediatrics (rarely used)
      • parenteral therapy is not used as it may cause renal failure
  • Mechanism of action
    • a glycopeptide that interferes with peptidoglycan synthesis, disrupting the cell wall
  • Clinical use
    • primarily staphylococcal and group A streptococcal infections
    • superficial bacterial infections
    • pneumonia or empyema
      • limited use for pediatric patients who failed to respond to less-toxic antibiotics
  • Adverse effects
    • nephrotoxicity
    • contact dermatitis
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