Mupirocin Dosing Recommendations
For topical skin infections, apply a small amount of mupirocin 2% ointment to the affected area three times daily for up to 10 days. 1
Topical Skin Application
Mupirocin is a unique topical antibiotic that inhibits bacterial protein and RNA synthesis, with excellent activity against staphylococci and streptococci, making it ideal for treating superficial skin infections.
Standard Dosing for Skin Infections:
- Frequency: Apply 3 times daily
- Duration: Up to 10 days
- Method: Apply with cotton swab or gauze pad to affected area
- Coverage: May cover with gauze dressing if desired
- Evaluation: Re-evaluate patients not showing clinical response within 3-5 days 1
Specific Indications:
- Impetigo: Apply to lesions twice daily 2
- Limited lesions: Mupirocin ointment is particularly effective for patients with a limited number of lesions 2
- Pediatric use: Safe and effective for minor skin infections such as impetigo and secondarily infected skin lesions in children 2
Nasal Decolonization
For MRSA decolonization and prevention of recurrent infections:
Standard Nasal Dosing:
- Frequency: Apply twice daily to anterior nares
- Duration: 5-7 days 2
- Alternative regimen: Apply twice daily for the first 5 days each month (reduces recurrences by ~50%) 2
Decolonization Protocol:
For recurrent staphylococcal infections, a 5-day decolonization regimen is recommended:
- Intranasal mupirocin twice daily
- Daily chlorhexidine washes
- Daily decontamination of personal items (towels, sheets, clothes) 2
Clinical Considerations
Efficacy:
- Mupirocin has demonstrated over 90% clinical cure or improvement in patients with skin infections 3
- For nasal carriage, elimination of S. aureus (including MRSA) was achieved in over 95% of subjects 3
Precautions:
- Not for intranasal, ophthalmic, or other mucosal use (except when specifically prescribed for nasal decolonization) 1
- Do not apply concurrently with other lotions, creams, or ointments 1
- High-level resistance to mupirocin has been associated with subsequent failure of decolonization 2
Monitoring:
- Monitor for local reactions, which occur in less than 3% of patients 4
- For skin infections, clinical response should be evident within 3-5 days; if not, re-evaluation is necessary 1
Special Populations
Children:
- Safe for use in pediatric patients with minor skin infections 2
- Particularly effective for impetigo in children 4
Recurrent Infections:
- For patients with recurrent furunculosis, nasal decolonization with mupirocin can be an effective preventive strategy 2
- Consider combining with systemic antibiotics for severe recurrent infections 2
Mupirocin's unique structure and mechanism of action make it less likely to develop cross-resistance compared to other topical antibiotics, making it a valuable option for treating superficial skin infections and MRSA decolonization 4.