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Pronunciation:

(myoo PEER oh sin)

U.S. Brand Names:

Bactroban®; Bactroban® Nasal; Centany™

Synonyms:

Mupirocin Calcium; Pseudomonic Acid A

Generic Available:

Yes: Topical ointment

Canadian Brand Names:

Bactroban®

Use:

Intranasal: Eradication of nasal colonization with MRSA in adult patients and healthcare workers

Topical treatment of impetigo due to Staphylococcus aureus, beta-hemolytic Streptococcus, and S. pyogenes

Use - Unlabeled/Investigational:

Intranasal: Surgical prophylaxis to prevent wound infections

Pregnancy Risk Factor:

Pregnancy Implications:

There are no adequate and well-controlled studies in pregnant women; use during pregnancy only if clearly needed.

Lactation:

Excretion in breast milk unknown/use caution

Contraindications:

Hypersensitivity to mupirocin, polyethylene glycol, or any component of the formulation

Warnings/Precautions:

Potentially toxic amounts of polyethylene glycol contained in the vehicle may be absorbed percutaneously in patients with extensive burns or open wounds; prolonged use may result in over growth of nonsusceptible organisms; for external use only; not for treatment of pressure sores

Adverse Reactions:

Frequency not defined.

Central nervous system: Dizziness, headache

Dermatologic: Pruritus, rash, erythema, dry skin, cellulitis, dermatitis

Gastrointestinal: Nausea, taste perversion

Local: Burning, stinging, tenderness, edema, pain

Respiratory: Rhinitis, upper respiratory tract infection, pharyngitis, cough

Drug Interactions:

No data reported

Stability:

Do not mix with Aquaphor®, coal tar solution, or salicylic acid

Compatibility:

Do not mix with Aquaphor®, coal tar solution, or salicylic acid.

Mechanism of Action:

Binds to bacterial isoleucyl transfer-RNA synthetase resulting in the inhibition of protein and RNA synthesis

Pharmacodynamics/Kinetics:

Absorption: Topical: Penetrates outer layers of skin; systemic absorption minimal through intact skin

Protein binding: 95%

Metabolism: Skin: 3% to monic acid

Half-life elimination: 17-36 minutes

Excretion: Urine

Dosage:

Children 12 years and Adults: Intranasal: Approximately one-half of the ointment from the single-use tube should be applied into one nostril and the other half into the other nostril twice daily for 5 days

Children 3 months and Adults: Topical: Apply small amount to affected area 2-5 times/day for 5-14 days

Patient Education:

For external use only. Wash hands before and after application. Apply thin film over affected areas exactly as directed. Avoid getting in eyes. Report rash, persistent burning, stinging, swelling, itching, or pain. Contact prescriber if no improvement is seen in 3-5 days. Breast-feeding precaution: Consult prescriber if breast-feeding.

Nursing Implications:

Not for treatment of pressure sores in elderly patients; contains polyethylene glycol vehicle

Additional Information:

Not for treatment of pressure sores; contains polyethylene glycol vehicle.

Dental Health: Effects on Dental Treatment:

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Mental Health: Effects on Mental Status:

None reported

Mental Health: Effects on Psychiatric Treatment:

None reported

Dosage Forms:

Cream, topical, as calcium (Bactroban®): 2% (15 g, 30 g) [contains benzyl alcohol]

Ointment, intranasal, topical, as calcium (Bactroban® Nasal): 2% (1 g) [single-use tube]

Ointment, topical: 2% (22 g)

Bactroban®: 2% (22 g)

Centany™: 2% (15 g, 30 g)

International Brand Names:

Bactoderm® (ID, IL); Bactroban® (AR, AT, AU, BE, BR, CA, CH, CL, CO, CR, CZ, DK, DO, ES, FI, FR, GB, GT, HK, HN, HU, ID, IE, IL, IN, IT, KW, LU, MX, NL, NZ, PA, PL, PT, RO, RU, SE, SG, SV, TH, TR, YU, ZA); Bactroban Nasal® (CH, FI, GB, IE, IL, SE); Betrion® (HR, SI); Infectopyoderm® (DE); Mupiderm® (FR); Mupirocina® (BR); Mupirocin-Teva® (IL); Mupirox® (AR, PL); Muporin® (TH); Plasimine® (ES); Seladerm® (EC); Turixin® (DE); Underan® (CL)

References

Blumer JL, Lemon E, O'Horo J, et al, "Changing Therapy for Skin and Soft Tissue Infections in Children: Have We Come Full Circle?"Pediatr Infect Dis J, 1987, 6(1):117-22.

Britton JW, Fajardo JE, and Krafte-Jacobs B, "Comparison of Mupirocin and Erythromycin in the Treatment of Impetigo,"J Pediatr, 1990, 117(5):827-9.

Goldfarb J, Crenshaw D, O'Horo J, et al, "Randomized Clinical Trial of Topical Mupirocin Versus Oral Erythromycin for Impetigo,"Antimicrob Agents Chemother, 1988, 32(12):1780-3.

Perl TM, Cullen JJ, Wenzel RP, et al, "Intranasal Mupirocin to Prevent Postoperative Staphylococcus aureus Infections,"N Engl J Med, 2002, 346(24):1871-7.

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