Drug reference

Mupirocin

Antibacterial · Antibiotic

Also known as Bactroban Nasal, Centany, Mupin, T-Bact, Mupirocin calcium

AntibacterialAntibiotic

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

Manufacturer advises to avoid unless potential benefit outweighs risk; no information available.

FDA category + note

Mechanism

Mupirocin inhibits bacterial protein synthesis by reversibly binding to and inhibiting bacterial isoleucyl transfer-RNA synthetase. This action prevents the incorporation of isoleucine into bacterial proteins. Resistance can occur through mutations in the host gene for isoleucyl transfer-RNA synthetase or by the acquisition of an extrachromosomal gene (mupA) encoding a modified synthetase that binds mupirocin poorly, leading to high-level resistance. There is no cross-resistance with other antibiotic classes.

Indications

Eradication of nasal carriage of staphylococci (including MRSA)FurunculosisFolliculitisImpetigoInfected insect bitesSmall woundsDecolonization to eliminate nasal colonization with S. aureusPost-discharge decolonization following S. aureus bacteremiaIntranasal decolonization for recurrent S. aureus infections in the community

Dosing

Adult: Intranasal: Apply 2–3 times a day for 5 days to the inner surface of each nostril. A sample should be taken 2 days after treatment to confirm eradication. Course may be repeated once if sample positive (and throat not colonised). Dermatologic (2% ointment/cream): Apply thrice daily.
Pediatric: Intranasal: Apply 2–3 times a day for 5 days to the inner surface of each nostril. A sample should be taken 2 days after treatment to confirm eradication. Course may be repeated once if sample positive (and throat not colonised).
Renal adjustment: Manufacturer advises caution when mupirocin ointment is used in moderate or severe impairment due to macrogol (polyethylene glycol) content.

Pharmacokinetics

Bioavailability

Minimal systemic absorption through intact skin or skin lesions.

Metabolism

Rapidly metabolized to inactive monic acid.

Excretion

Absorbed mupirocin is rapidly metabolized to inactive monic acid.

Side effects

Common

Skin reactionsNasal mucosal disorder (uncommon)Local itchingIrritationRedness

Pregnancy & lactation

Pregnancy

Manufacturer advises to avoid unless potential benefit outweighs risk; no information available.

Lactation

No information available.

Drug interactions

None

Moderate

Database

Due to its topical application and rapid metabolism, mupirocin has a very low potential for systemic drug-drug interactions. There are no well-documented, clinically significant drug-drug interactions with other commonly prescribed drugs, including those in India.

No specific management required for drug-drug interactions with mupirocin. Prescribe as indicated for topical bacterial infections.