Mupirocin

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications: 

• Primary and secondary bacterial skin infections caused by Staphylococcus aureus and other susceptible organisms (cre, oin)
  - Primary skin infections: Impetigo, folliculitis, furunculosis and ecthyma (cre, oin)
  - Secondary infections: Infected dermatoses e.g., infected eczema. Infected traumatic lesions e.g., abrasions, insect bites, minor (not requiring hospitalisation) wounds and burns (cre, oin)
• Prophylaxis to avoid bacterial contamination of small wounds, incisions and other clean lesions, and to prevent infection of abrasions and small cuts and wounds (cre, oin)
• Intranasal treatment of colonisation of the nasal passages by Staphylococcus strains including methicillin-resistant Staphylococcus aureus strains (intranasal oin)

Registered South African contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Treatment of skin lesions infected with Pseudomonas aeruginosa (cre,oin)
• Mupirocin intranasal formulation is not suitable for ophthalmic use

• Pregnancy
• Breastfeeding
• Moderate to severe renal impairment (oin)
• Renal impairment (intranasal)
• Use in conjunction with cannulae (oin)
• At the site of central venous cannulation (oin)
• Prolonged use
• Ophthalmic use (cre, intranasal)
• Intranasal use (cre)
• Contact with the eyes

Forms avail. in SA and covered in this monograph: cre, oin

Infections caused by commonly susceptible species: Staphylococcus aureus, Streptococcus spp. (β-haemolytic, other than S. pyogenes)

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

South African registered indications and dosages

Primary and secondary bacterial skin infections caused by Staphylococcus aureus and other susceptible organisms
- Primary skin infections: Impetigo, folliculitis, furunculosis and ecthyma
- Secondary infections: Infected dermatoses e.g., infected eczema. Infected traumatic lesions e.g., abrasions, insect bites, minor (not requiring hospitalisation) wounds and burns
Prophylaxis to avoid bacterial contamination of small wounds, incisions and other clean lesions, and to prevent infection of abrasions and small cuts and wounds

• Topical (cre, oin): Apply small quantity to the affected area, 2-3 times a day; Treatment duration: 10 days, depending on response

Method of administration (topical)

Before applying ointment, wash affected areas and dry thoroughly

Mupirocin is for topical use only. A small quantity of should be applied to cover the affected area. The treated area may be covered by a dressing

Intranasal treatment of colonisation of the nasal passages by Staphylococcus strains including methicillin-resistant Staphylococcus aureus strains

• Intranasal (oin): Apply small quantity, about the size of a match head (approximately 30mg of ointment) to each nostril, twice a day; Treatment duration: 5 days; Max duration: 10 days

Method of Administration (intranasal)

Use a cotton tipped applicator. After application, the nostrils should be closed by pressing the sides of the nose together several times

For topical and intranasal preparations: Any product remaining at the end of treatment should be discarded. Do not mix with other preparations as there is a risk of dilution, resulting in a reduction in the antibacterial activity and potential loss of stability of the mupirocin in the cream or ointment. Not for long-term use

Paed. forms avail in SA and covered in this monograph: cre, oin

Infections caused by commonly susceptible species: Staphylococcus aureus, Streptococcus spp. (β-haemolytic, other than S. pyogenes)

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

South African registered indications and dosages

Primary and secondary bacterial skin infections caused by Staphylococcus aureus and other susceptible organisms
- Primary skin infections: Impetigo, folliculitis, furunculosis and ecthyma
- Secondary infections: Infected dermatoses e.g., infected eczema. Infected traumatic lesions e.g., abrasions, insect bites, minor (not requiring hospitalisation) wounds and burns
Prophylaxis to avoid bacterial contamination of small wounds, incisions and other clean lesions, and to prevent infection of abrasions and small cuts and wounds

Younger than 2 months

• Topical (oin): Not established for use

Older than 2 months

• Topical (cre, oin): See adult dosages

Intranasal treatment of colonisation of the nasal passages by Staphylococcus strains including methicillin-resistant Staphylococcus aureus strains

• Intranasal (oin): No specific dosage recommendations per age group are provided

Pregnancy

• Caution
• Reproduction studies on mupirocin in animals have revealed no evidence of harm to the foetus
• As there is no clinical experience on its use during pregnancy, mupirocin should only be used in pregnancy when the potential benefits outweigh the possible risks of treatment

Breastfeeding

• Caution
• There is no information on the excretion of mupirocin in milk
• If a cracked nipple is to be treated, it should be thoroughly washed prior to breastfeeding

Fertility

• There are no data on the effects of mupirocin on human fertility. Studies in rats showed no effects on fertility

Renal Impairment

• No dose adjustment recommended (cre)
• Mild: No dose adjustment recommended (oin)
• Moderate to severe: Caution; no dose adjustment recommended (oin)
  Polyethylene glycol can be absorbed from open wounds and damaged skin and is excreted by the kidneys. In common with other polyethylene glycol-based ointments, mupirocin ointment should not be used in conditions where absorption of large quantities of polyethylene glycol is possible, especially if there is evidence of moderate or severe renal impairment
• Caution; no information available (nas)

Hepatic Impairment

• No dose adjustment recommended (cre, oin)
• Caution; no information available (nas)

Elderly

• No dose adjustment recommended

Porphyria Information

• Topical (cre, oin): Possibly porphyrinogenic (PSP)
• Topical (nas): Not yet classified (NC)

Drugs in Sport

•  Permitted - No warnings

Skin and Subcutaneous Tissue Disorders

• Application site hypersensitivity reactions
  - Urticaria
  - Pruritis
  - Erythema
  - Burning sensation
  - Contact dermatitis
  - Rash
  - Stinging
  - Itching
• Skin dryness  
• Nasal mucosa reactions (nas)

Immune, Blood and Lymphatic System Disorders

• Systemic allergic reactions
  - Anaphylaxis
  - Generalised rash
  - Urticaria
  - Angioedema

None known 

None routine

Mupirocin is a novel antibiotic produced through fermentation by Pseudomonas fluorescens. Mupirocin inhibits isoleucyl transfer-RNA synthetase, thereby arresting bacterial protein synthesis. Mupirocin has bacteriostatic properties at minimum inhibitory concentrations and bactericidal properties at the higher concentrations reached when applied locally.

Spectrum of activity: Staphylococcus aureus; Streptococcus pyogenes; Streptococcus spp. (β-haemolytic, other than S. pyogenes)

Cream (per 100g) 2g

• Bactroban (GSK) originator

Ointment (per 100g) 2g

• Bactroban (GSK) originator
• Banogon (Pharmacare)
• Dermoban (Unicorn)
• Nuban (Pharma Dynamics)
• Supiroban (Glenmark)

Nasal ointment (per 100g) 2g

• Bactroban nasal (GSK) originator