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Mupirocin

    DEA Class; Rx

    Common Brand Names; Bactroban, Bactroban Nasal, Centany

    • Antibacterials, Topical

    Unique topical antibiotic produced from Pseudomonas fluorescens; active against gram positive organisms like S. aureus and Strept. pyogenes; used for skin infections like impetigo; also in an intranasal ointment to eradicate nasal colonization of MRSA.

    Indicated for the treatment of impetigo and other skin and skin structure infections due to susceptible strains of Staphylococcus aureus or Streptococcus pyogenes.

    For methicillin-resistant S. aureus nasal carriage eradication to reduce the risk of infection among high-risk patients during institutional outbreaks.
    For the treatment of mild methicillin-resistant Staphylococcus aureus (MRSA)-associated infectious neonatal pustulosis.
    For the treatment of infected eczema† due to susceptible strains of Staphylococcus sp. or Streptococcus sp..
    For the treatment of folliculitis due to susceptible strains of Staphylococcus sp. or Streptococcus sp..
    For the prevention of postoperative nosocomial Staphylococcus aureus infections (i.e., bacterial infection prophylaxis).

    Hypersensitivity

    • Headache (1.7%)
    • Nausea (1.7%)
    • Burning (1-3%)
    • Stinging (1-3%)
    • Pain (1-3%)
    • Pruritus (1-3%)
    • Rash (1-3%)
    • Cellulitis (1%)
    • Dry skin (1%)
    • Erythema (1%)
    • Incr exudate (1%)
    • Pain or bleeding secondary to eczema (1%)
    • Secondary wound infection (1%)
    • Swelling (1%)
    • Tenderness (1%)
    • Urticaria (1%)

    Anaphylaxis, urticaria, angioedema, and generalized rash reported

    Manufacturer cautions against use of mupirocin ointment in burn patients, particularly those with extensive burns, since potentially toxic amounts of polyethylene glycol (PEG) contained in the vehicle may be absorbed percutaneously

    Avoid contact with eyes; in case of accidental contact, rinse well with water

    Discontinue use in event of sensitization or severe local irritation from ointment

    Clostridium difficile-associated diarrhea (CDAD) reported with use; if CDAD suspected or confirmed, discontinue ongoing antibacterial drug use not directed against C. difficile; institute appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. difficile, and surgical evaluation, as clinically indicated

    Prolonged use may result in overgrowth of nonsusceptible organisms, including fungi

    Not formulated for use on mucosal surfaces; intranasal use has been associated with isolated reports of stinging and drying

    Not for use in conditions where absorption of large quantities of polyethylene glycol possible, especially if there is evidence of moderate or severe renal impairment; polyethylene glycol can be absorbed from open wounds and damaged skin and is excreted by the kidneys

    Ointment should not be used with intravenous cannulae or at central intravenous sites because of the potential to promote fungal infections and antimicrobial resistance

    There are insufficient human data to establish whether there is drug-associated risk with therapy in pregnant women

    Not known whether mupirocin is present in human milk, has effects on breastfed child, or has effects on milk production

    Adults

    Intranasal, 5 days of twice daily therapy; Topical, maximum dosage information is not available.

    Geriatric

    Intranasal, 5 days of twice daily therapy; Topical, maximum dosage information is not available.

    Adolescents

    Intranasal, 5 days of twice daily therapy; Topical, maximum dosage information is not available.

    Children

    12 years: Intranasal, 5 days of twice daily therapy; Topical, maximum dosage information is not available.
    1 to 11 years: Maximum dosage information is not available for topical ointment or cream. Safety and efficacy not established for intranasal ointment; however, intranasal ointment has been used off-label.

    Infants

    3 months and older: Maximum dosage information is not available for topical ointment or cream. Safety and efficacy not established for intranasal ointment; however, intranasal ointment has been used off-label.
    2 months: Maximum dosage information is not available for topical ointment. Safety and efficacy not established for topical cream or intranasal ointment; however, intranasal ointment has been used off label.
    younger than 2 months: Safety and efficacy not established; however, topical and intranasal ointment have been used off-label.
     

    Neonates

    Safety and efficacy not established; however, topical ointment has been used off-label.

    Mupirocin calcium

    cream/topical ointment

    • 2%

    nasal ointment

    • 2%