Snapshot 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