From the Guidelines
Mupirocin ointment is the primary recommendation for treating Methicillin-resistant Staphylococcus aureus (MRSA) wounds. It should be applied to the affected area three times daily for 5-10 days. The standard concentration is 2% mupirocin, and it's essential to clean the wound gently with soap and water before each application.
Key Considerations
- For more extensive or severe MRSA infections, topical treatment alone may be insufficient, and oral antibiotics like trimethoprim-sulfamethoxazole, doxycycline, or linezolid might be necessary alongside the ointment.
- Mupirocin works by inhibiting bacterial protein synthesis, specifically targeting the isoleucyl-tRNA synthetase enzyme, which prevents MRSA from producing essential proteins needed for survival.
- If the infection doesn't improve within 3-5 days of treatment, or if symptoms worsen (increasing redness, swelling, pain, or fever), medical attention should be sought immediately as systemic antibiotics or drainage may be required.
Additional Treatment Options
- According to the guidelines 1, for patients with carbuncles or abscesses who have failed initial antibiotic treatment or have markedly impaired host defenses or in patients with SIRS and hypotension, an antibiotic active against MRSA is recommended.
- The guidelines also suggest that incision and drainage is the recommended treatment for inflamed epidermoid cysts, carbuncles, abscesses, and large furuncles 1.
Important Notes
- It's crucial to follow the treatment guidelines and seek medical attention if symptoms persist or worsen.
- The treatment options may vary depending on the severity of the infection and the patient's overall health.
- The use of antibiotics should be guided by culture results and susceptibility testing whenever possible 1.
From the Research
Ointment for MRSA Wounds
- Mupirocin ointment is highly effective in controlling MRSA burn wound infection and should be applied topically every 24 hours 2.
- Topical treatment with mupirocin is significantly more effective than systemic treatment with linezolid and vancomycin in eradicating MRSA in skin wounds 3.
- Mupirocin cream is as effective as oral cephalexin in the treatment of secondarily infected wounds, including small lacerations, abrasions, or sutured wounds 4.
- Mupirocin nasal ointment may be prescribed for decolonization prior to surgical procedures, especially for carriers of MRSA, with a 10-dose regimen being superior to any 6-dose regimen for de-colonizing S. aureus from the anterior nares of patients 5.
- High-level mupirocin resistance was identified in 1.4% of MSSA and 14.1% of MRSA, respectively, highlighting the need for alternative treatment options 6.
- Other topical antimicrobials, such as retapamulin and fusidic acid, may also be effective in treating MRSA wounds, with retapamulin being significantly more effective than systemic treatment with linezolid and vancomycin 3.
- Ozenoxacin is active against SSTI pathogens, including MRSA resistant to fluoroquinolones, macrolides, clindamycin, fusidic acid, and mupirocin, making it a potential alternative treatment option 6.