Bactroban (Mupirocin) for Laceration Treatment
Mupirocin 2% ointment applied three times daily is effective for treating secondarily infected lacerations and can be used as an alternative to oral antibiotics for localized wound infections without systemic signs. 1, 2, 3
When to Use Mupirocin for Lacerations
For secondarily infected lacerations with limited involvement:
- Apply mupirocin 2% ointment to the affected area three times daily 2
- Treatment duration is typically 5-10 days 4, 2
- The area may be covered with gauze dressing if desired 2
- Clinical efficacy rates for secondarily infected wounds (including lacerations) are approximately 95%, equivalent to oral cephalexin 3
Mupirocin is appropriate when:
- The infection is localized to the laceration site 1
- No systemic signs of infection are present (no fever, no signs of systemic toxicity) 1, 5
- The patient has limited lesions, not extensive or widespread infection 1
When NOT to Use Mupirocin
Switch to systemic antibiotics if:
- Signs of systemic toxicity develop (fever, hypotension, altered mental status) 6, 1
- Extensive cellulitis surrounds the laceration 6, 1
- No clinical response occurs within 3-5 days of topical therapy 4, 2
- The patient has markedly impaired host defenses or immunocompromise 5
Systemic Antibiotic Alternatives
If oral antibiotics are needed instead:
- Cephalexin 25-50 mg/kg/day divided into 3-4 doses 4, 5
- Clindamycin 10-20 mg/kg/day if MRSA suspected and local resistance <10% 1, 4
- Dicloxacillin 25-50 mg/kg/day as alternative 4
Laceration Repair Considerations
For pain control during laceration repair:
- Use topical anesthetic combinations (lidocaine, epinephrine, tetracaine) applied 20-30 minutes before repair 6
- Consider tissue adhesives or absorbable sutures to avoid removal pain 6
Common pitfall: Do not confuse localized inflammation around a laceration with true cellulitis requiring systemic antibiotics. The primary treatment for purulent collections is drainage, not antibiotics alone. 6 Mupirocin works well for superficial wound infections but cannot replace incision and drainage when pus is present. 5
Re-evaluate patients not showing clinical response within 3-5 days and consider switching to systemic therapy or investigating for deeper infection. 2