Also found in: Wikipedia.


(re-ta-pam-yoo-lin) ,


(trade name)


Therapeutic: anti infectives
Pharmacologic: pleuromutilins
Pregnancy Category: B


Topical treatment of impetigo caused by methicillin-susceptibleStaphylococcus aureus or Streptococcus pyogenes.


Interferes with bacterial protein synthesis at the level of the 50S ribosome.

Therapeutic effects

Bacteriostatic action against susceptible organisms.


Absorption: Minimal systemic absorption.
Distribution: Unknown.
Metabolism and Excretion: Small amounts absorbed are extensively metabolized.
Half-life: Unknown.

Time/action profile

TopicalUnknownUnknown12 hr


Contraindicated in: No contraindications.
Use Cautiously in: Obstetric: Use only in pregnancy when maternal benefit outweighs fetal risk; safe use during lactation not established; Pediatric: Safe use in children <9 mos not established.

Adverse Reactions/Side Effects


  • application site irritation


Drug-Drug interaction

Strong CYP3A4 inhibitors, including ketoconazole may ↑ levels; concomitant use not recommended in children <24 mo.


Topical (Adults and Children ≥9 mos) Apply thin layer to affected area (up to 100 cm2 in adults or 2% total body area in children) twice daily for 5 days.


Ointment: 10 mg/g in 5, 10 and 15 g tubes

Nursing implications

Nursing assessment

  • Assess lesions before and daily during therapy.
  • Monitor for application site irritation (redness, itching, burning, swelling, blistering, oozing). Discontinue, wipe off ointment and use alternative therapy if irritation occurs.

Potential Nursing Diagnoses

Risk for infection (Indications)
Risk for impaired skin integrity (Adverse Reactions)


  • Topical: Apply a thin layer to affected area twice daily for 5 days. May be covered with sterile bandage or gauze if desired; may protect from access by infants and young children or accidental transfer to eyes or other areas. Wash hands after application if hands are not area of treatment. Avoid oral, intranasal, ophthalmic, or intravaginal use.

Patient/Family Teaching

  • Instruct patient or parent on correct application technique. Advise patient to apply medication exactly as directed for full course of therapy, even though symptoms have improved.
  • Teach patient and family appropriate hygienic measures to prevent spread of impetigo.
  • Instruct parents to notify school nurse for screening and prevention of transmission.
  • Advise patient to notify health care professional if application site irritation occurs or if there is no improvement within 3–4 days.

Evaluation/Desired Outcomes

  • Healing of skin lesions.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
Current treatments include a new topical antibiotic, ozenoxacin (Xepi), retapamulin (Altabax), and the old topical treatments such as mupirocin and fusidic acid (not available in the United States), which are still widely used as first-line therapies.
First-line treatment for impetigo consists of the use of topical application of mupirocin (Bactroban) 2% ointment, retapamulin (Altabax) 1% ointment, or fusidic acid 2% cream.
Antimicrobial drug use for children <1-17 years of age, Uppsala County, Sweden, 2015 * Drug DDD/1,000 person-days Phenoxymethylpenicillin 2.44 Amoxicillin 0.59 Flucloxacillin 0.56 Amoxicillin/clavulanic acid 0.20 Trimethoprim/sulfamethoxazole 0.18 Cefadroxil 0.16 Erythromycin 0.13 Pivmecillinam 0.08 Clindamycin 0.06 Ceftibuten 0.06 Nitrofurantoin 0.05 Azithromycin 0.05 Ciprofloxacin 0.05 Cloxacillin 0.03 Meropenem 0.02 Cefotaxime 0.02 Metronidazole 0.02 Benzylpenicillin 0.01 Vancomycin 0.01 Piperacillin/tazobactam 0.01 * The following drugs had DDD values <0.01/1,000 person-days: coxycycline, ampicillin, cefuroxime, ceftazidime, ceftriaxone, ertapenem, imipenem, ceftaroline fosamil, tobramycin, gentamicin, moxifloxacin, colistin, daptomycin, rifampin, retapamulin, and fusidic acid.
A different GP was consulted, who prescribed griseo fulvin, retapamulin ointment, Tetmosol soap, cloxacillin and chlorpheniramine maleate, with no advice to stop the previously prescribed drugs.
Commonly used topical agents include bacitracin, cefazolin, ciprofloxacin, gentamycin, impenem, mupirocin, neomycin, polymyxin, retapamulin, and benzoyl peroxide.
There is currently one semisynthetic pleuromutilin, retapamulin available on the market and the potential to now expand and employ the reported gene expression technique and develop further new antibiotics from new derivatives must be like a treasure trove waiting to be opened by the drug discovery gurus.
A / ALTHOUGH EVIDENCE IS LACKINGING to support a single best treatment for impetigo, topical mupirocin, fusidic acid, gentamicin, and retapamulin are all at least 20% more likely than placebo to produce cure or improvement (strength of recommendation [SOR]: A, meta-analysis of randomized controlled trials [RCTs] and a single RCT of retapamulin).
Rosen turns to retapamulin ointment (Altabax) instead.
For example, a small percentage of nonpregnant adults had measurable plasma concentrations of retapamulin (Altabax), a topical antibiotic, but the levels were very low (less than 1 ng/mL).
The 52nd edition features entries for new drugs including Aliskiren, Ambrisentan, Armodafinil, Eculizumab, Lapatinib, Levocetirizine, Retapamulin, and Temsirolimus.