Your Patients Need Bacitracin/Polymyxin B — Here's How to Help Them Get It

As a provider, you've likely heard from patients who can't fill their Bacitracin/Polymyxin B ophthalmic ointment prescription. The ongoing shortage that began in 2024 continues to affect pharmacies nationwide, and patients are turning to you for help.

This guide offers a practical, step-by-step approach to help your patients access Bacitracin/Polymyxin B — or transition smoothly to an effective alternative when it's not available.

Current Availability Overview

As of early 2026, Bacitracin/Polymyxin B ophthalmic ointment remains in limited supply:

• Padagis discontinued production in July 2024; estimated resupply is October 2026
• Other manufacturers may have intermittent stock, but supply is inconsistent
• Chain pharmacies (CVS, Walgreens, Rite Aid) frequently report out-of-stock status
• Independent and compounding pharmacies may have better availability

Why Patients Can't Find It

Understanding the supply landscape helps you communicate effectively with patients:

• Single-manufacturer dependency: Padagis was a primary supplier, and their exit left a major gap
• Few generic alternatives in this exact formulation: Unlike many antibiotics with multiple generic manufacturers, bacitracin ophthalmic has limited competition
• Complex manufacturing process: Bacitracin requires bacterial fermentation, making rapid production increases difficult
• Patient-level hoarding: Some patients and pharmacies stockpile when supply appears, exacerbating scarcity for others

What Providers Can Do: 5 Steps

Step 1: Check Availability Before Prescribing

Before writing a Bacitracin/Polymyxin B prescription, take 30 seconds to check availability using Medfinder for Providers. This real-time tool shows which pharmacies in your patient's area currently have stock. Sending a patient to a pharmacy that doesn't carry the medication wastes their time and delays treatment.

Step 2: Prescribe with Alternatives in Mind

If Bacitracin/Polymyxin B isn't available, be prepared to pivot quickly. Consider including a note on the prescription or in the patient's chart with your preferred alternative, so your staff can respond quickly if the pharmacy calls.

Recommended alternatives by clinical scenario:

• Uncomplicated bacterial conjunctivitis: Erythromycin 0.5% ophthalmic ointment
• Suspected gram-negative infection: Tobramycin 0.3% drops or ointment
• Moderate-to-severe infection or corneal involvement: Ciprofloxacin 0.3% (Ciloxan) drops or ointment
• Broad-spectrum coverage needed: Levofloxacin 1.5% ophthalmic drops

Step 3: Direct Patients to Pharmacy Finder Tools

Empower your patients to take action. Recommend they visit Medfinder to search for pharmacies with Bacitracin/Polymyxin B in stock. You can include this information on patient handouts or discharge instructions:

"If your pharmacy doesn't have this medication, visit medfinder.com to find a pharmacy near you that has it in stock."

Step 4: Consider Independent and Compounding Pharmacies

When chain pharmacies are out of stock, independent pharmacies often have more flexibility:

• They may work with multiple wholesalers and distributors
• They can sometimes source from secondary markets
• Some have sterile compounding capabilities (USP 797) to prepare equivalent ophthalmic formulations

If you have relationships with local compounding pharmacies, keeping them in your referral network during shortages can be valuable.

Step 5: Communicate Proactively with Patients

Patients cope better with shortages when they understand the situation. A brief explanation goes a long way:

• "This medication is in a nationwide shortage right now because the main manufacturer stopped production temporarily."
• "I'm prescribing [alternative] instead, which treats the same type of infection effectively."
• "If you'd prefer to try finding the original medication, here's a tool that can help: medfinder.com"

Alternatives at a Glance

Here's a quick reference for the most common alternatives:

• Erythromycin Ophthalmic Ointment: Gram-positive coverage; safe in neonates; widely available; $15-$30 with coupon
• Tobramycin (Tobrex): Gram-negative focused including Pseudomonas; drops or ointment; $15-$40 with coupon
• Ciprofloxacin (Ciloxan): Broad-spectrum; drops or ointment; $10-$30 with coupon; preferred for corneal ulcers
• Levofloxacin Ophthalmic: Enhanced gram-positive coverage; drops only; good for resistant cases
• Neosporin Ophthalmic (Bacitracin/Neomycin/Polymyxin B): Triple antibiotic; may also be affected by bacitracin supply issues; higher allergy risk from neomycin

Direct patients to our comparison guide: alternatives to Bacitracin/Polymyxin B.

Workflow Tips for Your Practice

To minimize disruption from the shortage, consider these workflow adjustments:

• Flag in your EHR: Add a clinical decision support alert or note that Bacitracin/Polymyxin B is in shortage. This prompts providers to consider alternatives at the point of prescribing.
• Pre-authorize alternatives: Work with your practice to establish standing alternative protocols, so support staff can facilitate switches without needing a new provider encounter.
• Batch patient communications: If you have patients on recurring Bacitracin/Polymyxin B prescriptions, consider a proactive outreach (portal message, letter) explaining the shortage and offering to switch them to an available alternative.
• Track shortage status: Assign a team member to monitor the ASHP or FDA shortage databases monthly and update your practice's medication availability notes.
• Bookmark Medfinder for Providers — quick real-time stock checks before writing prescriptions

Final Thoughts

The Bacitracin/Polymyxin B shortage is a manageable challenge when you're prepared. By checking availability before prescribing, having alternatives ready, and directing patients to tools like Medfinder, you can ensure treatment continuity without significant delays.

The shortage is expected to ease by late 2026, but proactive planning now prevents patient frustration and treatment gaps. For the latest shortage updates, see our provider shortage briefing.