From the Guidelines
Mupirocin should be applied intranasally twice daily for 5-10 days to treat nasal Staphylococcus aureus infections. This recommendation is based on the guidelines provided by the Infectious Diseases Society of America, as stated in the study published in 2011 1. The standard regimen involves placing a small amount of ointment on a cotton swab or fingertip and applying it to the inside front portion of each nostril.
Key Points to Consider
- Mupirocin works by inhibiting bacterial protein synthesis, specifically by binding to bacterial isoleucyl-tRNA synthetase, which prevents S. aureus from producing essential proteins needed for survival.
- This medication is particularly effective for decolonization of methicillin-resistant Staphylococcus aureus (MRSA) carriers and is often used before surgeries to reduce infection risk.
- Patients should complete the full course of treatment even if symptoms improve quickly to ensure complete eradication of the bacteria and prevent resistance development.
- Side effects are typically mild and may include local irritation, burning sensation, or headache.
Additional Considerations
- Decolonization strategies should be offered in conjunction with ongoing reinforcement of hygiene measures, as stated in the study published in 2011 1.
- Nasal decolonization with mupirocin twice daily for 5–10 days and topical body decolonization regimens with a skin antiseptic solution (eg, chlorhexidine) for 5–14 days or dilute bleach baths may also be considered, as mentioned in the study published in 2011 1.
- A 5-day decolonization regimen twice daily of intranasal mupirocin, daily chlorhexidine washes, and daily decontamination of personal items such as towels, sheets, and clothes for recurrent S. aureus infection may be considered, as stated in the study published in 2014 1.
From the Research
Mupirocin for Nasal Staphylococcus aureus Infection
- Mupirocin is used to treat nasal Staphylococcus aureus infections by applying a topical ointment to the nasal cavity.
- Studies have shown that mupirocin is effective in eradicating Staphylococcus aureus from the nose, with eradication rates ranging from 77% to 100% 2, 3, 4.
- The treatment typically involves a 5-day course of nasal mupirocin ointment, which can be repeated as needed to prevent recolonization 5, 4.
- Mupirocin has been compared to other antibiotics, such as bacitracin and neomycin, and has been found to be more effective in eliminating Staphylococcus aureus nasal colonization 2, 4.
Efficacy and Duration of Treatment
- The efficacy of mupirocin in treating nasal Staphylococcus aureus infections has been demonstrated in various patient populations, including healthcare workers, immunocompetent patients, and patients undergoing hemodialysis or peritoneal dialysis 2, 5, 3, 4.
- The duration of treatment with mupirocin can vary, but typical treatment courses range from 5 days to several weeks or months 5, 4.
- Recolonization with Staphylococcus aureus can occur after treatment with mupirocin, and periodic re-treatment may be necessary to maintain eradication 5, 4.