Polymyxin B/Trimethoprim Shortage Update: What Patients Need to Know in 2026

If you've been prescribed Polymyxin B/Trimethoprim eye drops (Polytrim) and had trouble filling the prescription, you're not imagining things. This antibiotic eye drop experienced a genuine supply disruption beginning in 2023, and the effects are still felt at some pharmacies in 2026. Here's what you need to know as a patient.

Is Polymyxin B/Trimethoprim Still in Shortage in 2026?

The short answer: the national-level shortage has largely resolved, but individual pharmacy stock-outs still happen. As of late 2024, both Bausch Health (Bausch + Lomb) and Sandoz — two major pharmaceutical manufacturers — have polymyxin B/trimethoprim ophthalmic solution in active production and available through wholesalers. The ASHP (American Society of Health-System Pharmacists), which formally tracks drug shortages in the U.S., noted this improvement in its November 2024 update.

However, 'nationally available' doesn't always mean 'available at your pharmacy.' Ordering patterns, wholesaler contracts, and local demand all affect what sits on the shelf at your specific location. So some patients still encounter empty shelves in 2026.

What Caused the Polymyxin B/Trimethoprim Shortage?

The shortage was triggered primarily by the February 2023 closure of Akorn, Inc., a major manufacturer of generic ophthalmic medications in the United States. Akorn had been a significant supplier of Polymyxin B/Trimethoprim ophthalmic solution. When the company shut down all operations, it removed a large share of market supply nearly overnight.

Compounding the problem, Greenstone (a subsidiary of Viatris) also discontinued their formulation around the same time. With two major generic manufacturers exiting the market simultaneously, pharmacies across the country faced back-order situations that lasted into late 2023 and beyond. The American Society of Health-System Pharmacists formally documented the shortage beginning March 31, 2023.

How Did the Drug Market Respond?

Bausch Health (the parent company of Bausch + Lomb, the original Polytrim brand holder) and Sandoz increased production to fill the gap left by Akorn and Greenstone. By late 2024, both companies had polymyxin B/trimethoprim sulfate ophthalmic solution listed as available. This is a meaningful improvement — though it took over a year for the supply chain to fully stabilize after Akorn's exit.

What Does This Mean for Patients in 2026?

The drug is being manufactured: Bausch and Sandoz are actively producing it — this is not a discontinued drug.

Stock varies by pharmacy: Not every pharmacy has it at any given moment. Checking multiple pharmacies is key.

Both generic versions are equivalent: Whether your pharmacy dispenses the Bausch or Sandoz version, both contain the same active ingredients at the same concentrations.

Alternatives are available: If you truly cannot find it, effective alternatives like ciprofloxacin or moxifloxacin eye drops can treat the same infection.

Tips for Finding It in 2026

Use medfinder: medfinder calls pharmacies near you to check real-time availability and texts you the results.

Try independent pharmacies: They often stock products that chain pharmacies don't carry or have exhausted.

Request a special order: Ask your pharmacy to order directly from their wholesaler — many can get it within 24–48 hours.

Ask your doctor about alternatives: If timing is critical, a fluoroquinolone eye drop may be faster to obtain.

The Bottom Line

The worst of the Polymyxin B/Trimethoprim shortage is behind us, but pharmacy-level gaps persist in 2026. The drug is available — finding it requires checking multiple locations. Use pharmacy-finding tools to save time, and always have a backup plan ready if one pharmacy can't fill your script.