Bacitracin overdose

Bacitracin can be poisonous in large amounts.

Bacitracin is found in certain over-the-counter antibiotic ointments such as Neosporin. It may also be found in some prescription eye ointments.

The medicine also comes in a form that can be given as a shot into a muscle or through a vein. Using it this way is the most common way for an overdose to occur.

Bacitracin is very safe. However, getting it in the eyes may cause redness and some pain and itching.

Eating bacitracin in large amounts may cause stomach pain and vomiting.

In rare cases, bacitracin can cause an allergic reaction, often redness and itching of the skin. If the reaction is severe, there may be difficulty swallowing or breathing.

Bacitracin is still used as a body-wide (systemic) antibiotic in parts of the world. If it is given by injection, it may cause pain in the area of the shot or a skin rash. It can also cause nausea, vomiting, and bone marrow and kidney failure.

People who are sensitive to neomycin, another antibiotic that is used on the skin, may also be sensitive to bacitracin.

If you have a reaction to bacitracin, stop using it. For serious reactions, seek emergency medical care right away.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the chemical was swallowed, give the person water or milk right away. Do not give water or milk if the person is vomiting or has a decreased level of alertness.

Call 911 or the poison control center or your local emergency number for assistance.

Have this information ready:

• The person's age, weight, and condition
• Name of product (as well as the ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

Your health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• Chest x-ray
• Electrocardiogram (ECG)

Treatment may include:

• Activated charcoal
• Breathing support, including oxygen, tube through the mouth into the lungs, and breathing machine (ventilator)
• Fluids through a vein (IV)
• Laxative
• Medicines to treat symptoms
• Skin and eye washing (irrigation) if the product touched these tissues and they are irritated or swollen

If an allergic reaction develops and is controlled, recovery is very likely. Survival beyond 24 hours usually is a sign that recovery is likely.

Polysporin ointment overdose

Aronson JK. Bacitracin. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:807-808.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.