Bacitracin is highly active against staphylococci, Streptococcus pyogenes, and C. difficile. Its high degree of activity against the group A streptococci is used in the laboratory as a means of differentiating between the Lancefield group A streptococci and other streptococci.
Bacitracin is well tolerated topically and orally and is frequently used in combination with other agents (no tably polymyxin B and neomycin) in the form of creams, ointments, and aerosol preparations. Hydrocortisone has been added to the combination for its an-tiinflammatory effects. Bacitracin preparations are effective in the treatment of impetigo and other superficial skin infections. However, poststreptococcal nephritis has followed the topical treatment of impetigo, and therefore oral penicillin therapy is preferred. Bacitracin has been used with limited success for eradication of S. aureus in the nares. Because of the risk of serious nephrotoxicity, the parenteral use of bacitracin is not justified.
GLYCOPEPTIDES: VANCOMYCIN AND TEICOPLANIN
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