From the Guidelines
Mupirocin is best used for treating bullous and nonbullous impetigo, and should be applied topically twice daily for 5 days. This recommendation is based on the strongest and most recent evidence from the Infectious Diseases Society of America, which suggests that topical mupirocin is an effective treatment for impetigo and ecthyma 1. The guidelines recommend treating bullous and nonbullous impetigo with either topical mupirocin or retapamulin twice daily for 5 days, with a strong and high level of evidence 1.
Some key points to consider when using mupirocin include:
- Applying a small amount of mupirocin ointment to the affected area twice daily
- Covering the area with a sterile bandage if recommended by your healthcare provider
- Completing the full course of treatment, even if symptoms improve quickly, to prevent antibiotic resistance
- Avoiding use of mupirocin for extended periods to prevent antibiotic resistance
- Being aware of the potential for low-level and high-level resistance to mupirocin in S. aureus, which can lead to treatment failure 1
It's also important to note that mupirocin can be used for nasal decolonization of MRSA, by applying a small amount inside each nostril twice daily for 5 days 1. However, the primary use of mupirocin is for treating localized skin infections, particularly impetigo and ecthyma, as recommended by the Infectious Diseases Society of America 1.
From the FDA Drug Label
Mupirocin has been shown to be active against most strains of Staphylococcus aureus and Streptococcus pyogenes, both in vitro and in clinical studies. Mupirocin is active against a wide range of gram-positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA).
Mupirocin is best used for treating infections caused by gram-positive bacteria, including Staphylococcus aureus and Streptococcus pyogenes, as well as methicillin-resistant Staphylococcus aureus (MRSA) 2. Key uses include:
- Treating impetigo
- Treating skin infections caused by susceptible bacteria 2.
From the Research
Mupirocin Uses
- Mupirocin is a topical antibiotic used to treat various skin infections, including impetigo and MRSA (Methicillin-resistant Staphylococcus aureus) infections 3, 4.
- It is effective against gram-positive bacteria, such as Staphylococcus aureus and Streptococcus pyogenes 4, 5.
- Mupirocin has been shown to be more effective than oral antibiotics, such as erythromycin, in treating impetigo and other skin infections 6.
- It can also be used to eradicate nasal carriage of Staphylococcus aureus, although more studies are needed to confirm its effectiveness for this use 4.
Resistance and Efficacy
- Mupirocin resistance has been reported, with high-level resistance exceeding 10% in MRSA isolates 5, 7.
- Despite this, mupirocin remains effective against many MRSA isolates, including those with high-level resistance to other antibiotics 7.
- Fusidic acid and retapamulin are alternative topical antibiotics that can be used to treat MRSA infections, although resistance to these agents has also been reported 5, 7.
- The choice of antibiotic should be guided by susceptibility testing and clinical judgment 5, 7.
Clinical Applications
- Mupirocin is commonly used to treat impetigo, a superficial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes 4, 6.
- It can also be used to treat other skin infections, such as wound infections and folliculitis, caused by gram-positive bacteria 4.
- Mupirocin may be used in combination with other antibiotics or treatments to enhance its effectiveness or prevent resistance 3, 4.