Bacitracin Shortage: A Provider Briefing for 2026

Bacitracin — one of the most commonly used topical antibiotics in the United States — is experiencing a significant supply disruption in 2026. While the over-the-counter topical formulation remains broadly available, the prescription ophthalmic ointment is in active shortage, and the injectable form has been permanently withdrawn from the market.

This article provides a comprehensive overview for clinicians, pharmacists, and prescribers on the current Bacitracin supply situation, prescribing implications, available alternatives, and resources to help your patients navigate the shortage.

Shortage Timeline

Understanding the sequence of events helps contextualize the current supply landscape:

• 1948: Bacitracin for injection originally approved by the FDA for infant pneumonia and empyema caused by susceptible staphylococci
• February 2020: FDA requests voluntary withdrawal of all Bacitracin for injection products from the market due to nephrotoxicity and anaphylaxis risks, given the availability of safer alternatives
• March 2021: FDA formally withdraws approval of five abbreviated new drug applications (ANDAs) for Bacitracin injection
• September 2022: Federal Register confirms Bacitracin injection was withdrawn for reasons of safety or effectiveness
• Early 2025: Padagis US temporarily discontinues Bacitracin ophthalmic ointment (500 units/g, 3.5g tube) — the primary Rx formulation
• Estimated October 2026: Padagis US estimates resupply of ophthalmic ointment

Prescribing Implications

The shortage has several clinical implications that prescribers should be aware of:

Ophthalmic Prescribing

Bacitracin ophthalmic ointment has been a staple for bacterial conjunctivitis, blepharitis, and post-operative prophylaxis in ophthalmology. With the current shortage, prescribers should:

• Consider Erythromycin ophthalmic ointment as a first-line alternative — it's widely available, covers similar gram-positive organisms, and is commonly used for neonatal prophylaxis
• Tobramycin ophthalmic drops or ointment for broader gram-negative coverage when clinically indicated
• Fluoroquinolone drops (Ciprofloxacin, Ofloxacin, Moxifloxacin) for more serious infections or when broader coverage is needed
• Polytrim (Polymyxin B/Trimethoprim) drops as another readily available combination option

Topical Wound Care

The OTC topical form is generally available, but providers should be aware of evolving evidence and guidelines:

• Multiple studies support petroleum jelly (Aquaphor, Vaseline) as equally effective for clean surgical and minor wound care, with the added benefit of avoiding antibiotic resistance and allergic sensitization
• For higher-risk wounds or impetigo, Mupirocin (Bactroban) remains the preferred prescription option, particularly given its MRSA activity
• The American Academy of Dermatology has increasingly endorsed petroleum-based emollients over antibiotic ointments for routine post-procedural wound care

Allergic Considerations

Bacitracin allergy is an important clinical consideration. Allergic contact dermatitis to Bacitracin is well-documented, and cases of anaphylaxis have been reported. Patients with a history of Bacitracin sensitivity should be steered toward Mupirocin or petroleum jelly for wound care, and non-Bacitracin-containing ophthalmic antibiotics for eye infections.

Current Availability Picture

Here's a summary of Bacitracin product availability as of early 2026:

• Bacitracin topical ointment (OTC): Generally available from multiple manufacturers. Retail price $2.52–$13.44. Spot shortages may occur.
• Bacitracin ophthalmic ointment (Rx): In shortage. Limited or no stock at most pharmacies. Estimated resupply October 2026.
• Bacitracin for injection: Permanently withdrawn. No longer available in the U.S.
• Combination products (Neosporin, Polysporin): Generally available OTC. Not directly affected by the ophthalmic shortage.

Cost and Access Considerations

Understanding the financial landscape helps when counseling patients:

• OTC topical: $2.52–$13.44. No prescription needed. Generally not covered by insurance.
• Rx ophthalmic: $10.20–$46.39 cash price. Typically Tier 1 on formularies when available. Discount cards (SingleCare, GoodRx) can reduce costs to approximately $10.20.
• Erythromycin ophthalmic (alternative): $10–$30 with coupons. Widely available.
• Mupirocin (alternative): $15–$75 without insurance; under $15 with discount cards.

For patients struggling with costs, general assistance programs through NeedyMeds and RxAssist may help with prescription expenses. There are no manufacturer-specific savings programs for Bacitracin, as it is an unbranded generic. See our patient-facing guide on saving money on Bacitracin for details you can share with patients.

Tools and Resources for Your Practice

Several tools can help you and your patients navigate the shortage:

Medfinder for Providers

Medfinder allows you and your patients to check real-time pharmacy stock for Bacitracin and other medications. You can direct patients to the platform to find pharmacies with stock before writing a prescription, reducing the frustration of unfillable prescriptions.

ASHP Drug Shortage Database

The American Society of Health-System Pharmacists (ASHP) maintains an updated drug shortage database with manufacturer information, estimated resupply dates, and suggested alternatives.

FDA Drug Shortage Database

The FDA's Drug Shortages database provides official information on current and resolved shortages, including the Bacitracin ophthalmic ointment shortage.

Patient Education Resources

You can direct your patients to the following Medfinder articles for self-service guidance:

• Bacitracin shortage update for patients
• How to find Bacitracin in stock
• Alternatives to Bacitracin

Looking Ahead

The Bacitracin ophthalmic shortage is expected to resolve by late 2026 when Padagis US resumes manufacturing. However, this situation highlights broader vulnerabilities in the pharmaceutical supply chain — particularly for sterile ophthalmic products with limited manufacturers.

Providers should consider:

• Proactively discussing alternatives with patients rather than waiting until a prescription can't be filled
• Documenting Bacitracin allergy status carefully, as it affects which alternatives are safe to prescribe
• Updating formulary preferences in your EHR to flag the shortage and suggest alternatives at the point of prescribing
• Educating patients about the difference between the OTC topical form (generally available) and the Rx ophthalmic form (in shortage)

Final Thoughts

The Bacitracin shortage is manageable with proactive prescribing and patient education. Effective alternatives exist for both wound care and ophthalmic indications. By using tools like Medfinder for Providers and staying current on shortage timelines, you can minimize disruption to your patients' care.

For additional clinical context, see our provider-focused guide on helping patients find Bacitracin in stock and our article on helping patients save money on Bacitracin.