Bacitracin: evidence, FDA status and research

It is an antibiotic ointment people put on cuts and scrapes to stop infection. In a trial of 922 patients it worked no better than plain petroleum jelly, and a few had allergic reactions.

Sold for

Bacitracin is the antibiotic in the first-aid kit, applied to scrapes and surgical wounds on the assumption that it prevents infection.

Studies say

In a 922-patient randomized trial, wounds treated with bacitracin got infected at the same low rate as wounds treated with plain petroleum jelly, and bacitracin caused allergic reactions that petrolatum did not (grade B).

Why grade B. Bacitracin's approval predates modern trial requirements. The best modern evidence for its everyday use, preventing infection in minor wounds, is a randomized double-blind trial of 922 dermatologic surgery patients in which bacitracin was no better than plain petrolatum on overall infection rate. One large trial with a null primary result for the popular use is grade B. ⁴

FDA. Bacitracin is FDA-approved and sold over the counter as a topical first-aid antibiotic ointment, alone and combined with neomycin and polymyxin B, for preventing infection in minor cuts, scrapes and burns. The injectable form, once used for staphylococcal pneumonia in infants, was withdrawn at the FDA's request in 2020 because of kidney toxicity. ¹²³

Written from 5 cited sources. Last refreshed 2026-10-27. Not physician reviewed.

What this means for you

What people take it for: Preventing infection in small cuts and scrapes
Can a US doctor prescribe it?: Yes, FDA approved for preventing infection in minor cuts, scrapes and burns (sold over the counter).
Properly tested in people?: Partly: one large trial of 922 patients found no clear gain over petroleum jelly.

Evidence checklist

Randomised controlled trial 922 surgery patients, double-blind vs petrolatumyes
Human study over 100 people 922 patients, 1,249 woundsyes
More than one research group Article cites one main trialno information
Clinical outcomes, not surrogate markers Infection and healing rates measuredyes
Human safety data beyond case reports Allergy rates reported; injectable withdrawnyes

Drawn from the cited studies below. A dash means the sources give no information.

What it is

Bacitracin is a mix of related ring-shaped peptide antibiotics. The bacterium Bacillus subtilis makes them. Doctors isolated it in 1945 from a culture grown from the wound of a girl named Margaret Tracy, hence the name. The main active part is bacitracin A. ¹²

Skin and gut absorb it poorly, so it suits use on the skin. It is sold alone (Baciguent and generics). It is also sold with neomycin and polymyxin B as triple antibiotic ointment (Neosporin and generics). An injectable form existed for decades. The US removed it from the market in 2020. ¹³

How it works

Bacitracin blocks the building of bacterial cell walls. It acts at a different step from penicillins. Bacteria use a fat-based carrier molecule (C55-isoprenyl pyrophosphate) to move wall building blocks across their membrane. Bacitracin binds this carrier and stops it from being recycled. Without the carrier, the wall cannot grow, and the bacterium dies. It works mainly against Gram-positive bacteria such as staphylococci and streptococci. ¹²

What human research shows

The key modern trial appeared in JAMA in 1996. At Walter Reed, researchers randomized 922 patients with 1,249 wounds after skin surgery. Patients got white petrolatum or bacitracin ointment, double-blind, for four weeks. Infection after surgery struck 2.0% of the petrolatum group and 0.9% of the bacitracin group. That gap was not statistically significant. Wound healing did not differ at days 1, 7 or 28. ⁴

Two smaller findings pointed in opposite directions. All eight Staphylococcus aureus infections were in the petrolatum group, and none were in the bacitracin group. That gap was statistically significant. But four patients (0.9%) in the bacitracin group developed allergic contact dermatitis. None in the petrolatum group did. The authors concluded that petrolatum worked equally well and carried less allergy risk. ⁴

Study	Model	Finding
Smack 1996, JAMA	Humans, n=922 (1,249 wounds), randomized double-blind, petrolatum versus bacitracin, 4 weeks	Infection rates 2.0% versus 0.9% (not significant); no S. aureus infections with bacitracin; allergic contact dermatitis only with bacitracin (0.9%). ⁴
Allergen of the Year 2003	Expert designation by the American Contact Dermatitis Society	Bacitracin recognised as a frequent cause of allergic contact dermatitis from first-aid use. ⁵

Safety

Allergic contact dermatitis is the main problem with bacitracin on the skin. It is common enough that the American Contact Dermatitis Society named bacitracin its Allergen of the Year in 2003. Frequent use on broken skin is thought to drive the allergy. Rare cases of anaphylaxis after use on the skin have been reported. ⁴⁵

Bacitracin that enters the whole body damages the kidneys. That is why the injectable form was withdrawn in 2020. Use on small wounds does not reach meaningful blood levels. ¹³

Questions for your clinician

Would plain petrolatum work as well as bacitracin for my wound?
Have I reacted to antibiotic ointments before, and could I be allergic?
When does a wound need a prescribed treatment instead of an ointment?

Questions people ask

Is bacitracin FDA-approved?

Yes, as an over-the-counter first-aid antibiotic for the skin, alone or in triple antibiotic ointment. In 2020 the FDA asked for the injectable version to leave the US market because of kidney toxicity. ¹³

Does bacitracin prevent wound infection better than petroleum jelly?

Not in the largest randomized trial. Among 922 surgical patients, infection rates were similarly low with either ointment. Bacitracin did prevent Staphylococcus aureus infections in particular. But it also caused allergic reactions that petrolatum did not. ⁴

Why do dermatologists discourage routine bacitracin?

Allergic contact dermatitis to it is common, and it was named Allergen of the Year in 2003. The trial evidence also shows no overall edge over petrolatum for clean minor wounds. ⁴⁵

Is it a peptide?

Yes. Bacitracin is a ring-shaped peptide made by bacteria. Most antibiotics are small molecules. Polymyxin B, its partner in triple antibiotic ointment, is also a peptide. ¹³

Citations

DrugBank: Bacitracin go.drugbank.com
StatPearls: Bacitracin topical statpearls.com
Medscape: Baciguent (bacitracin topical) drug reference reference.medscape.com
Smack 1996, JAMA: infection and allergy incidence with white petrolatum vs bacitracin ointment pubmed.ncbi.nlm.nih.gov
Pharmacy Times: bacitracin and boo-boos, becoming a no-no pharmacytimes.com