From the Guidelines
Mupirocin should not be used as a first-line treatment for burns, but rather reserved for confirmed or suspected infections, ideally after consultation with a healthcare provider. The primary approach to burn management involves cleaning the burn with mild soap and water, applying a petroleum-based ointment, and covering with a sterile non-stick dressing 1. Mupirocin, an antibiotic ointment, is specifically designed to treat bacterial skin infections, particularly those caused by Staphylococcus aureus and Streptococcus species.
Some key points to consider when managing burns include:
- Cleaning the burn with mild soap and water to prevent infection
- Applying a petroleum-based ointment to promote healing and protect the wound
- Covering the burn with a sterile non-stick dressing to reduce the risk of infection
- Monitoring for signs of infection, such as increasing pain, redness, swelling, warmth, pus, foul odor, or fever, which may require medical attention and potentially the use of mupirocin or other antibiotics 1.
It's essential to note that routine prophylactic antibiotic use is discouraged in burn management, as it can promote antibiotic resistance 1. Mupirocin, in particular, has been shown to be effective in reducing MRSA colonization, but its use should be judicious and guided by clinical judgment, taking into account the potential risks and benefits, as well as the latest evidence from studies such as those published in the Clinical Infectious Diseases journal 1.
In terms of application, when prescribed for infected burns, mupirocin is typically applied in a thin layer to the affected area three times daily for 7-10 days 1. However, this should only be done under the guidance of a healthcare provider, who can assess the burn and determine the best course of treatment.
From the Research
Mupirocin for Burns
- Mupirocin is a topical antibiotic that has been shown to be effective in treating burn wounds infected with methicillin-resistant Staphylococcus aureus (MRSA) 2.
- A study found that a single topical application of mupirocin resulted in a 98.3% reduction in intra-eschar viable organisms within 36 hours post-application, and a second application at 24 hours resulted in a total reduction of 99.6% in viable intra-eschar organisms 2.
- Mupirocin has been compared to other topical antimicrobial agents, such as silver sulfadiazine and fusidic acid, and has been found to be equally effective in reducing local burn wound bacterial count and preventing systemic infection 3.
Comparison to Silver-Containing Dressings
- Silver-containing dressings are commonly used to prevent infection and promote healing in burn wounds, but evidence of their effectiveness is limited 4, 5, 6.
- A systematic review found that silver-containing dressings were either no better or worse than control dressings in preventing wound infection and promoting healing of burn wounds 4.
- Another review found that most guidelines recommend the use of silver-containing dressings for most scenarios, but there is currently no ideal topical antimicrobial agent that can be recommended for all clinical scenarios 5.
Efficacy of Mupirocin in Burn Wounds
- Mupirocin has been shown to be highly effective in controlling MRSA burn wound infection, with a significant reduction in viable intra-eschar organisms within 36 hours post-application 2.
- A comparison of mupirocin with other topical antimicrobial agents found that it was equally effective in reducing local burn wound bacterial count and preventing systemic infection 3.
- However, more research is needed to fully establish the efficacy of mupirocin in burn wounds and to compare it to other topical antimicrobial agents 2, 3.