Clinical Experience
- Mupirocin 2% (Bactroban®, GlaxoSmithKline) is a topical antibacterial drug structurally unrelated to other agents and acts by inhibiting bacterial protein synthesis.
- Clinical experience shows that this is a safe, effective and well-tolerated topical antibiotic available both in a cream and ointment.
- It is very effective for localized impetigo as well as for skin lesions that have become secondarily infected with Staph or Strep, and is associated with fewer adverse effects than systemic antibiotic therapy.
Mechanism of Action
- Mupirocin inhibits bacterial protein synthesis by reversibly and specifically binding to bacterial isoleucyl transfer-RNA synthetase.
- Importantly, as a result, this product shows no cross-resistance with chloramphenicol, erythromycin, fusidic acid, gentamicin, lincomycin, methicillin, neomycin, novobiocin, penicillin, streptomycin and tetracycline.
Indications
- Mupirocin 2% is indicated for the treatment of superficial skin infections caused by susceptible organisms.
- Systemic anti-infective agents are generally required for treating serious, deep, or extensive skin infections.
- Mupirocin has excellent activity against
- S. aureus
- S. epidermidis
- S. pyogenes
- and ß-hemolytic streptococci.
Infections
- Impetigo
- Secondary infection to skin trauma
- Lacerations / Sutured wounds / Abrasions
- Conditions that frequently have secondary infections
- Eczema / Burns / Superficial ulcers
- Nasal Staphylococcal Carriage
- Clears S. aureus
- Clears methicillin resistant S. aureus (MRSA) – Slide 6a
- Clearance may not be permanent, so re-treatment is usually required
Intranasal mupriocin is effective for the elimination of staphylococci, even MRSA, from chronic carriers.
Burns
- Mupirocin may be advantageous for topical treatment of staphylococcus-infected burns, especially those colonized with MRSA.
- Experts recommend that mupirocin be used on burns encompassing less than 20% of body surface and for less than 5 days.
[Antimicrob Agents Chemother. 1989; 33:1358-61.]
Summary of Indications
Topical Cream: Secondarily infected traumatic skin lesions caused by susceptible strains of S. aureus and S. pyogenes.
Topical Ointment: Impetigo, superficially infected dermatoses and lesions that are moist and weeping caused by S. aureus, ß-hemolytic streptococcus and S. pyogenes.
Bactroban® Cream is as good as the ointment for treating the above indications and is cosmetically more acceptable.
[Compendium of Pharmaceuticals and Specialties, 36th Ed. Ottawa: Canadian Pharmacists’ Association (2001).]
