Is There a Prescription Strength Bacitracin, and How Is It Used?

October 12, 2025 •

3 min read

While single-ingredient topical bacitracin is widely available over-the-counter, a prescription strength bacitracin is reserved for specific medical applications. This distinction is critical for understanding its appropriate use, especially concerning eye infections versus minor skin wounds.

Quick Summary

Bacitracin for skin is over-the-counter, but a prescription-only version exists as an eye ointment. Higher strength or systemic forms are now rare due to safety concerns.

Key Points

OTC for Minor Skin Wounds: The bacitracin ointment typically sold for minor cuts and scrapes is a standard 500 units/gram strength and is available without a prescription.
Prescription for Eye Infections: A specific ophthalmic (eye) ointment form of bacitracin is available by prescription only for treating bacterial eye infections.
No Higher Topical Strength for Skin: There is no higher, prescription-strength concentration of bacitracin for skin infections. Instead, doctors prescribe alternative antibiotics for more serious infections.
Oral and Injectable Forms Discontinued: Historical systemic uses of bacitracin (injections and oral) are now rare or discontinued due to significant toxicity, particularly to the kidneys.
Prescription Alternatives Exist: For more severe skin infections like impetigo, physicians often prescribe a different topical antibiotic, such as mupirocin, which is more effective than OTC bacitracin.
Allergy Risk: Bacitracin is a frequent cause of allergic contact dermatitis, an itchy rash that can be mistaken for a worsening infection.
Consult a Professional: Always consult a healthcare provider for severe wounds, eye infections, or if a minor wound does not improve, to determine the most appropriate treatment.

Over-the-Counter Bacitracin for Minor Wounds

The most common form of bacitracin available to the public is an over-the-counter (OTC) topical ointment, typically found in single-antibiotic or combination products. This is not considered a "prescription strength" version, but rather the standard concentration available for minor cuts, scrapes, and burns. It is primarily used to prevent infection rather than to treat established, serious infections.

Concentration: The standard OTC bacitracin ointment contains 500 units of bacitracin per gram.
Mechanism: It works by interfering with the synthesis of the bacterial cell wall, a mechanism effective against many Gram-positive bacteria like Staphylococci and Streptococci.
Application: This topical form is applied directly to the wound after cleaning, usually one to three times daily.
Combinations: Many popular products, like Neosporin, combine bacitracin with other antibiotics such as neomycin and polymyxin B to broaden their spectrum of coverage.

The Prescription-Only Ophthalmic Bacitracin

While bacitracin ointment for skin is OTC, a prescription-only formulation exists for eye infections. This is known as bacitracin ophthalmic ointment and is used to treat bacterial infections of the eye, such as conjunctivitis. Due to the sensitive nature of the eye and the need for a precise diagnosis, this product is not sold over the counter.

Specific Use: Treating superficial bacterial infections of the cornea and conjunctiva.
Prescription Requirement: A doctor's prescription is necessary to ensure the infection is bacterial and that bacitracin is the appropriate treatment.
Application: The ointment is applied directly into the conjunctival sac, not on the eyelids, and requires careful handling to prevent contamination.
Side Effects: Temporary blurred vision is a common side effect of ophthalmic ointment application.

When a Healthcare Provider Prescribes a Different Antibiotic

For serious or systemic infections, a healthcare provider will not prescribe a higher concentration of topical bacitracin due to its limitations and potential for toxicity. Instead, they will use different, more potent antibiotics. For example, a prescription-only topical antibiotic called mupirocin (Bactroban) is often used for skin infections like impetigo, which are more severe than minor cuts. Historically, bacitracin was used systemically (by injection) and orally, but these uses were largely discontinued due to severe toxicity, particularly to the kidneys (nephrotoxicity).

Comparing Topical Antibiotics: OTC vs. Prescription

To better understand the differences, consider this comparison table of common topical antibacterial treatments:


Feature	OTC Bacitracin Ointment	Prescription Ophthalmic Bacitracin	Prescription Mupirocin (Bactroban)
Availability	Over-the-counter	Prescription only	Prescription only
Primary Use	Prevention of infection in minor skin cuts, scrapes, and burns	Treatment of bacterial eye infections (conjunctivitis)	Treatment of more serious skin infections (e.g., impetigo)
Form	Topical skin ointment	Ophthalmic (eye) ointment	Topical ointment or cream
Common Side Effects	Itching, rash, irritation, allergic contact dermatitis	Temporary blurred vision, eye irritation	Burning, stinging, itching at application site
Concentration	Typically 500 units/gram	Varies by brand and formulation	2% concentration
Best for	Minor, superficial wounds	Specific bacterial eye infections as diagnosed by a doctor	Established, moderate to severe skin infections

Risks and Considerations

Despite its long history, bacitracin is not without risks, and prolonged use can lead to complications. It is particularly known for causing allergic contact dermatitis, a skin reaction that can present as an itchy rash, redness, or swelling. Bacitracin was named the 'Allergen of the Year' in 2003 due to the high incidence of sensitization in the population. The rash can sometimes be mistaken for a worsening infection, highlighting the importance of professional medical advice if symptoms persist. Systemic absorption, though minimal with topical application on intact skin, can increase significantly on large open wounds or burns, potentially leading to nephrotoxicity. For this reason, it should not be used on large areas of the body.

Conclusion

In summary, the concept of a "prescription strength bacitracin" is primarily a misnomer for skin applications, as the standard 500 units/gram ointment is available over-the-counter. The critical distinction lies in its specialized, prescription-only ophthalmic form for treating bacterial eye infections. For more significant or widespread skin infections, physicians bypass topical bacitracin altogether in favor of more potent and targeted prescription antibiotics like mupirocin. The historical use of injectable bacitracin is a notable exception, discontinued due to severe toxicity concerns. Therefore, while bacitracin has a place in the medicine cabinet for minor wound care, anything more serious warrants a consultation with a healthcare professional to explore stronger, safer prescription options.

This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for the diagnosis and treatment of any medical condition. ^1

Frequently Asked Questions

Bacitracin eye ointment requires a prescription because its use in the sensitive eye area must be carefully monitored by a doctor. A healthcare professional needs to ensure the infection is bacterial and that bacitracin is the correct medication for your specific eye condition.

No, you cannot get a stronger bacitracin for a skin infection. If you have a more serious infection that a standard over-the-counter product cannot treat, your doctor will prescribe a different, more powerful antibiotic, such as mupirocin.

Signs of an allergic reaction to bacitracin include itching, redness, swelling, and a rash at the application site. In rare cases, more serious reactions can occur, but contact dermatitis is most common. If you experience these symptoms, stop using the product and contact a healthcare provider.

Bacitracin is effective for minor, superficial bacterial infections. However, for more serious, resistant, or deeper infections, other prescription antibiotics like mupirocin or oral options are more effective. The most important factor is using the right antibiotic for the specific type of infection.

The main difference is that bacitracin is a single-antibiotic ointment, while Neosporin is a combination product that also contains neomycin and polymyxin B. Some people are allergic to neomycin, making bacitracin a better choice for them.

No, you should never use over-the-counter bacitracin ointment on your eyes. This can be harmful and is not the correct formulation for ophthalmic use. Only use prescription bacitracin ophthalmic ointment for eye infections under a doctor's supervision.

Historically, bacitracin was available in oral and injectable forms, but these are no longer commonly used for infections due to a high risk of toxicity, especially to the kidneys. Oral use for C. difficile was explored but is now rare.