Bacitracin Shortage: A Provider Briefing for 2026

Bacitracin, one of the most commonly used topical antibiotics in both clinical and consumer settings, is facing significant supply disruptions in 2026. While the over-the-counter topical ointment remains broadly available, the ophthalmic formulation is in an active shortage with an extended timeline for resolution. Additionally, the injectable formulation has been permanently withdrawn from the U.S. market.

This briefing covers the clinical and practical implications for providers managing patients who require Bacitracin or its alternatives.

Shortage Timeline

• March 2025 — Padagis US announced a temporary discontinuation of Bacitracin ophthalmic ointment (500 units/g, 3.5-gram tubes).
• Estimated resupply: October 2026 — Per ASHP Drug Shortage reporting, Padagis expects production to resume by late 2026, representing an approximately 18-month supply gap.
• Bacitracin for injection — Voluntarily withdrawn at the FDA's request due to nephrotoxicity and anaphylaxis risks. No resupply expected; this withdrawal is permanent.
• OTC topical ointment — Not in systematic shortage. Available at most retail pharmacies and online retailers.

Prescribing Implications

Ophthalmic Use

For superficial bacterial infections of the cornea and conjunctiva previously treated with Bacitracin ophthalmic ointment, the most straightforward substitution is:

• Erythromycin ophthalmic ointment (0.5%) — Covers many of the same gram-positive organisms. Well-tolerated with a favorable safety profile. This is the primary alternative most ophthalmology departments have adopted during the shortage.
• Tobramycin ophthalmic drops/ointment — Broad gram-negative coverage; useful when Pseudomonas or other gram-negatives are suspected.
• Fluoroquinolone ophthalmic drops (Ciprofloxacin, Ofloxacin, Moxifloxacin) — Broad-spectrum options for moderate to severe infections; reserve for cases requiring broader coverage to preserve antimicrobial stewardship.
• Polymyxin B/Trimethoprim ophthalmic drops — Another alternative with broad coverage against common ocular pathogens.

Topical/Wound Care Use

Bacitracin topical ointment remains available OTC and does not require prescribing changes in most cases. However, for patients who specifically need a prescribed topical antibiotic:

• Mupirocin 2% ointment (Bactroban) — Effective against MRSA and most skin pathogens; appropriate for impetigo, secondary skin infections, and wound prophylaxis in high-risk patients.
• Polysporin (Bacitracin + Polymyxin B) — OTC; provides broader gram-negative coverage than Bacitracin alone.
• Petroleum jelly — Evidence supports equivalent wound healing outcomes for clean minor wounds. Consider recommending this to patients as a non-antibiotic option to reduce unnecessary antibiotic use.

Cross-Sensitivity Considerations

Patients with known Bacitracin allergy may exhibit cross-sensitivity to Polymyxin B. Avoid Polysporin and triple-antibiotic ointments in these patients. Allergic contact dermatitis from Bacitracin is well-documented, and providers should be aware that Bacitracin is a common contact sensitizer — it was named Allergen of the Year by the American Contact Dermatitis Society in 2003.

Availability Picture

Current availability as of March 2026:

• Bacitracin topical ointment (OTC) — Widely available. Cash price: $5–$13 for a 14–28g tube.
• Bacitracin ophthalmic ointment (Rx) — Active shortage. Very limited or unavailable at most pharmacies. Compounding may be an option in select markets.
• Bacitracin for injection — Permanently withdrawn from market.
• Combination products — Neosporin and Polysporin remain available OTC.

Cost and Access Considerations

Because the OTC topical formulation is inexpensive ($5–$13) and does not require a prescription, cost is generally not a barrier for patients needing wound care.

For the ophthalmic formulation during the shortage, Erythromycin ophthalmic ointment is also generic and affordable, typically $10–$30 even without insurance. Most insurance formularies cover it without prior authorization.

Mupirocin, if prescribed as a topical alternative for skin infections, ranges from $15–$75 without insurance but is available for as low as $10 with discount programs like GoodRx or SingleCare.

Tools and Resources for Your Practice

To help your patients navigate availability challenges:

• Medfinder for Providers — A free tool that allows providers and patients to search for medication availability by location. Recommend this to patients who are having difficulty filling prescriptions.
• ASHP Drug Shortage Resource Center — For the latest shortage status updates and clinical guidance.
• Compounding pharmacy networks — For patients who specifically require Bacitracin ophthalmic ointment, compounding pharmacies may be able to prepare it. Connect patients with local compounding resources.

For patient-facing resources you can share, consider our guides on Bacitracin alternatives and how to find Bacitracin in stock.

Looking Ahead

The Bacitracin ophthalmic ointment shortage is expected to resolve by late 2026 based on manufacturer estimates, but timelines can shift. In the meantime:

• Proactively switch affected patients to Erythromycin ophthalmic ointment or other appropriate alternatives.
• Update prescribing workflows and EHR order sets to flag Bacitracin ophthalmic as limited availability.
• Educate patients that the OTC topical ointment is not affected by the shortage.
• Monitor ASHP and FDA shortage databases for updates on resupply.

For guidance on helping patients manage costs, see our provider guide on helping patients save money on Bacitracin.

Final Thoughts

The Bacitracin supply situation in 2026 is manageable with proactive prescribing and good patient communication. The ophthalmic shortage is the most clinically significant issue, with Erythromycin ophthalmic ointment serving as the most direct substitute. Use Medfinder for Providers to help your patients locate medications efficiently, and stay informed through ASHP shortage alerts.