From the Guidelines
Mupirocin (Bactroban) is recommended for treating localized skin infections, particularly those caused by Staphylococcus aureus and Streptococcus species, with a standard treatment involving applying a small amount of mupirocin 2% ointment to the affected area three times daily for 5 days, as supported by the most recent guidelines from 2018 1. The medication should be applied to clean, dry skin after gently washing the infected area with mild soap and water. Some key points to consider when using mupirocin include:
- Applying a thin layer to cover the infection, which may be covered with a sterile bandage if needed
- Completing the full course of treatment even if symptoms improve earlier to prevent recurrence and antibiotic resistance
- Washing hands before and after application to prevent spreading the infection
- Mupirocin works by inhibiting bacterial protein synthesis, specifically by binding to bacterial isoleucyl-tRNA synthetase, which prevents the incorporation of isoleucine into bacterial proteins
- If the infection worsens, spreads, or doesn't improve within 3-5 days, patients should seek medical attention as oral antibiotics may be necessary
- Mupirocin should not be used in the eyes or nose unless specifically directed by a healthcare provider for MRSA decolonization, as noted in guidelines from 2011 1 and 2014 1. It's also important to note that while mupirocin is effective against many strains of Staphylococcus aureus and Streptococcus species, resistance has been reported, and alternative treatments may be necessary in some cases, as discussed in guidelines from 2005 1.
From the FDA Drug Label
Mupirocin ointment, 2% is indicated for the topical treatment of impetigo due to: Staphylococcus aureus and Streptococcus pyogenes. The recommended treatment for skin infections using topical antibiotics like mupirocin is to apply mupirocin ointment, 2% topically to the affected area, as it is indicated for the treatment of impetigo caused by Staphylococcus aureus and Streptococcus pyogenes 2.
- Key points:
- Use mupirocin ointment, 2% for topical treatment of impetigo
- Follow the instructions of your healthcare practitioner
- Avoid contact with the eyes
- Stop the medication and contact your healthcare practitioner if irritation, severe itching, or rash occurs 2.
From the Research
Topical Antibiotics for Skin Infections
- Topical antibiotics like mupirocin are effective in treating skin infections, including those caused by meticillin-resistant Staphylococcus aureus (MRSA) 3.
- Mupirocin has been shown to have antimicrobial activity against staphylococci, streptococci, Hemophilus influenzae, and Neisseria gonorrhoeae 4.
- Studies have compared mupirocin to other topical antibiotics and oral antibiotics, with mupirocin demonstrating favorable results in the treatment of impetigo and secondary skin infections 4, 5.
Treatment Outcomes
- Clinical response to mupirocin ointment has been reported as 86% cured and 13% improved, with all pathogens originally isolated being eliminated, including Gram-negative organisms 5.
- Mupirocin (2 percent) ointment has been approved for use in the treatment of impetigo and has potential for use in other primary and secondary skin infections 6.
- Topical antibiotics like mupirocin may be preferable to systemic treatment due to maximizing effective doses at the site of infection while minimizing systemic side effects 7.
Comparison to Other Antibiotics
- Mupirocin has been compared to fusidic acid, with both demonstrating effectiveness in treating skin infections 3, 7.
- Fusidic acid has been shown to have a low risk of resistance and a low risk of contact sensitization, making it a first-choice option in the treatment of primary and secondary skin infections 7.
- Mupirocin has been reported to have fewer adverse effects than systemic antibiotics and is less expensive and easier to administer 6.