Polycin Ointment (Bacitracin / Polymyxin B)

Route restriction: Not for injection into the eye, and never to be introduced directly into the anterior chamber.

Corneal wound healing: Ophthalmic ointments may retard corneal wound healing.

Cutaneous sensitization: Topical antibiotics may sensitize, primarily as skin rash, at an incidence that is not known; ocular manifestations are usually itching, reddening, and edema of the conjunctiva and eyelid.

Failure to heal: A sensitization reaction may present simply as failure to heal, so examine periodically during long-term use and discontinue if such signs appear, after which products containing these ingredients should be avoided.

Aminoglycoside cross-reactions: Allergic cross-reactions may preclude later use of kanamycin, paromomycin, streptomycin, and possibly gentamicin.

Superinfection and resistance: Prolonged use may allow overgrowth of nonsusceptible organisms including fungi, and bacterial resistance may develop.

Container contamination: Bacterial keratitis has been reported after inadvertent patient contamination of multiple-dose topical ophthalmic containers, most of those patients having concurrent corneal disease or a disrupted ocular epithelial surface.