Pseudomonic acid A

mupirocin /mu·pir·o·cin/ (mu-pir´o-sin) an antibacterial derived from Pseudomonas fluorescens, effective against staphylococci and non-enteric streptococci; used topically in the treatment of impetigo and, intranasally as the calcium salt, in the treatment of nasal colonization by Staphylococcus aureus.

mupirocin [mu-pir´o-sin]

an antibacterial derived from Pseudomonas fluorescens, effective against staphylococci and non-enteric streptococci; used in the treatment of impetigo and, as the calcium salt, in the treatment of nasal colonization by Staphylococcus aureus.

mupirocin

a bacteriostatic antibiotic produced by Pseudomonas fluorescens and used topically, mainly against gram-positive bacteria.

mupirocin (pseudomonic acid, pseudomonic acid A)

Bactroban, Bactroban Nasal 2%

Pharmacologic class: Dermatologic agent

Therapeutic class: Anti-infective, topical

Pregnancy risk category B

Action

Inhibits bacterial protein and RNA synthesis by reversibly and specifically binding to bacterial isoleucyl-transfer RNA synthetase. Bactericidal.

Availability

Intranasal ointment: 2.15%

Topical cream: 2%

Topical ointment: 2%

⊘Indications and dosages

➣ Impetigo

Adults and children ages 2 months to 16 years: Apply a small amount of ointment topically t.i.d. for 3 to 5 days. Reevaluate if no response.

➣ Infected traumatic skin lesions

Adults and children ages 3 months to 16 years: Apply a small amount of cream topically t.i.d. for 10 days.

➣ Nasal colonization of methicillin-resistant Streptococcus aureus

Adults and children ages 12 and older: Apply intranasal ointment (half of single-use tube to each nostril) topically to anterior nares b.i.d. for 5 days.

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• moderate or severe renal impairment (with large doses)
• breastfeeding patients
• children younger than age 12 (intranasal ointment), younger than age 3 months (cream), or younger than age 2 months (ointment).

Administration

• After intranasal application, press nares together repeatedly to distribute drug.
• Avoid contact with eyes.
• Discontinue use if sensitization or severe local irritation occurs.
• If desired, cover affected area with gauze dressing after applying cream or ointment.
• Don't use intranasal form with any other nasal spray.
• Don't use Bactroban ointment on mucosal surfaces. Use Bactroban Nasal (mupirocin calcium ointment) intranasally.
• Know that although mupirocin isn't absorbed systemically, polyethylene glycol (its water-miscible ointment base) may be absorbed from open wounds and damaged skin and may be excreted by the kidneys.

Route	Onset	Peak	Duration
Topical, intranasal	Not systemically absorbed	Not systemically absorbed	Not systemically absorbed

Adverse reactions

CNS: headache (with intranasal use)

EENT: rhinitis, nasal stinging or burning, pharyngitis (all with intranasal use)

GI: mouth and lip sores

Skin: pruritus (with intranasal use); dry skin, rash, redness, stinging or pain, secondary wound infection

Other: taste disorders (with intranasal use)

Interactions

None significant

Patient monitoring

• Monitor for drug efficacy.

Patient teaching

• Instruct patient to wash affected area with soap and water and dry it thoroughly, then apply small amount of drug to area and rub in gently. If desired, tell him to apply gauze dressing.
• Advise patient to complete entire course of therapy, even if symptoms disappear. Tell him to try not to miss doses.
• If patient misses a dose, tell him to apply dose as soon as he remembers. However, if it's almost time for next dose, advise him to skip missed dose and resume regular dosing schedule.
• Advise patient to contact prescriber if skin infection doesn't improve within 3 to 5 days or if it worsens.
• Caution patient not to apply drug to eye or mucous membranes (except nasal form for intranasal use).
• As appropriate, review all other significant adverse reactions.