From the Guidelines
Bacitracin-polymyxin B ointment can be used for certain types of blepharitis, particularly bacterial blepharitis, as it has been shown to provide symptomatic relief and decrease bacteria from the eyelid margin in cases of anterior blepharitis 1.
Key Points to Consider
- The treatment of blepharitis often requires a combination of approaches, including warm compresses, eyelid cleansing, and topical antibiotics, with the goal of reducing symptoms and preventing complications 1.
- Bacitracin-polymyxin B ointment is typically applied as a thin strip to the eyelid margins 2-3 times daily after gentle cleansing of the eyelids, with treatment usually continuing for 7-10 days, though the duration may vary based on the specific condition and response to treatment 1.
- It is essential to note that not all forms of blepharitis are bacterial in nature; some cases are related to skin conditions like seborrheic dermatitis or Demodex mite infestations, which may require different treatments 1.
- Warm compresses and eyelid hygiene (gentle cleansing with diluted baby shampoo or commercial eyelid cleansers) are fundamental components of blepharitis management, regardless of whether antibiotics are used 1.
Important Considerations for Treatment
- The patient's ability to perform eyelid cleansing and warm compresses safely and effectively should be assessed, and the therapeutic plan should be tailored accordingly 1.
- Proper counseling of patients with neurotrophic corneas is crucial to avoid injury to the corneal epithelium 1.
- If symptoms persist despite treatment, alternative treatments may be needed, and consultation with an eye care provider is recommended 1.
From the FDA Drug Label
INDICATIONS AND USAGE: For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by Bacitracin susceptible organisms. The FDA drug label does not answer the question.
From the Research
Treatment Options for Blepharitis
- The mainstay of treatment for blepharitis is an eyelid hygiene regimen, which needs to be continued long term 2.
- Topical antibiotics are used to reduce the bacterial load, and topical corticosteroid preparations may be helpful in patients with marked inflammation 2.
- A study compared the efficacy of different treatment options in patients with chronic blepharitis, including eyelid hygiene with neutral shampoo, topical metronidazole gel, and neomycin and polymyxin antibiotic ointment with dexamethasone 3.
- The study found that all treatment groups showed significant improvement in signs and symptoms, but the group using neomycin and polymyxin antibiotic ointment with dexamethasone showed no clinical improvement for certain symptoms such as itching and dry eye 3.
Use of Bacitracin-Polymyxin B in Blepharitis
- There is no direct evidence in the provided studies that specifically mentions the use of bacitracin-polymyxin B for blepharitis.
- However, a study evaluated the efficacy and safety of trimethoprim in combination with polymyxin B alone (without sulfacetamide) in patients with bacterial conjunctivitis or blepharitis, and found it to be effective in eliminating bacteria from the eyes of patients 4.
- Another study discussed the use of topical antibiotics, including polymyxin B, in the treatment of blepharitis, but did not specifically mention bacitracin-polymyxin B 5.