Medications and Drugs
Pharmacy Author: Eni Williams, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: mupirocin, mupirocin calcium
BRAND NAME: Bactroban, Bactroban Nasal, Centany
DRUG CLASS AND MECHANISM: Mupirocin is an antibiotic that is used
topically (on the skin) for the treatment of impetigo, a bacterial disease of the
skin caused by Staphylococcus aureus, beta-hemolytic streptococcus and
Streptococcus pyogenes. It also is used intranasally (inside the nose) by
patients and some people who work in healthcare centers to eliminate
methicillin-resistant Staphylococcus aureus (MRSA) that have colonized the
inside of the nose.
Unlike most other antibiotics which act on either bacterial
DNA or the walls of bacteria, mupirocin blocks the activity of an enzyme called
isoleucyl-tRNA synthetase within the bacteria. This enzyme is necessary in order
for the bacteria to make proteins. Without the ability to make proteins, the
bacteria die. Because of its unique mechanism of action, there is little chance
that bacteria will have become resistant to mupirocin because of exposure to
other antibiotics. Mupirocin topical cream was approved by the FDA in December
1987. The intranasal form was approved in October 1995.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Ointment: 15 g tubes as 2% (20 mg/g). Cream: 15 and 30 g
tubes as 2% (20mg/g). Nasal ointment: 1 g tubes as 2% (20 mg/g).
STORAGE: The tablets should be kept at room temperature, 15-30 C
(59-86 F).
PRESCRIBED FOR: Mupirocin is used for the treatment of impetigo and
infections of the skin caused by
Staphylococcus aureus, beta-hemolytic
streptococcus or Streptococcus pyogenes. Mupirocin is not recommended for use on
the skin in serious burns, because more of the vehicle (the inactive ingredient)
used for the ointment, polyethylene glycol
(Miralax), may be absorbed and can damage the
kidneys. The nasal ointment of mupirocin is used for the elimination of nasal
Staphylococcus aureus that have become
resistant to other antibiotics. Mupirocin
also may be used for other infections as determined by the physician.
DOSING: For the treatment of impetigo, a small amount of the ointment
is applied to the affected area, usually three times daily. The area may be
covered with a sterile gauze dressing. If there is no improvement in 3-5 days,
the physician should be contacted to re-examine the infected area. For other
skin infections, the cream is applied to the affected area 3 times a day for 10
days, and the doctor should be contacted as well if there is no improvement
after 3-5 days.
When mupirocin is used for patients who harbor intranasal Staphylococcus
aureus that are resistant to many other antibiotics, those who are age 12 years and
older require the application of about half of the ointment from a single-use
tube of nasal ointment into one nostril and the other half into the other
nostril. This treatment is repeated twice daily for 5 days. Currently, there is
not enough information to recommend use of mupirocin in children younger than 12
years of age.
DRUG INTERACTIONS: There are no known drug interactions with
mupirocin; however, it should not be used at the same time with other drugs that
are applied inside the nose.
PREGNANCY: There are no adequate studies of mupirocin in
pregnant
women; however, studies in animals suggest no important effects on the fetus.
Mupirocin, therefore, can be used in pregnancy if the physician feels that it is
necessary.
NURSING MOTHERS: There is no information on the safety of mupirocin in
nursing infants. It is unknown if any of the small amount of mupirocin that is
absorbed from the skin into the blood of the mother concentrates in
breast milk.
It is advisable, therefore, not to nurse while using mupirocin.
SIDE EFFECTS: Side effects are uncommon and mild with mupirocin. The
most frequent side effects are burning, stinging, pain, and itching at the area
of application.
The intranasal use of mupirocin can cause headache (1 of every 11 patients),
runny nose (1 in 17), congestion (1 in 20), sore throat (1 in 22), changes in
taste perception (1 in 30), nasal irritation (1 in 50) and cough (1 in 50).
Reference: FDA Prescribing Information
Last Editorial Review: 2/19/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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