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Bacitracin: a unique topical antibiotic sensitizer
1Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, NY.
Journal of the American Academy of Dermatology
|December 1, 1987
Summary
Topical bacitracin is a frequent sensitizer causing allergic reactions like contact dermatitis and anaphylaxis. Delayed patch test reactions are common, and it may cross-react with other antibiotics.
Area of Science:
- Dermatology
- Allergology
- Clinical Immunology
Background:
- Topical bacitracin is increasingly recognized as a sensitizer.
- It can elicit diverse allergic reactions, from contact dermatitis to anaphylaxis.
- Unique properties include delayed patch test reactions and potential histamine release.
Purpose of the Study:
- To document clinical and patch test findings in patients with bacitracin-induced allergic contact dermatitis.
- To highlight the unique sensitizing potential and reaction patterns of topical bacitracin.
Main Methods:
- Retrospective review of nine patients diagnosed with allergic contact dermatitis to bacitracin ointment over one year.
- Clinical evaluation and patch testing with bacitracin.
Main Results:
- Nine patients presented with allergic contact dermatitis to bacitracin ointment.
- Reactions included delayed eczematous contact dermatitis and immediate urticarial responses.
- Patch test readings at 96 hours were often more informative than standard 48-hour readings.
Conclusions:
- Topical bacitracin is a significant cause of allergic contact dermatitis.
- Clinicians should consider bacitracin as a potential allergen, especially post-surgery.
- Awareness of delayed patch test reactions and potential cross-reactivity is crucial for diagnosis.