Mupirocin

Brand names of mupirocin

  • Bactroban
  • Bactroban Nasal

Mupirocin is a topical antibiotic used to treat impetigo. Being topical means it is used on the skin, not internally, and impetigo is a skin disease caused by some bacteria like Streptococcus pyogenes, beta-hemolytic streptococcus, or Staphylococcus aureus. It can also be used intranasally, which means inside the nostrils, to eliminate the methicillin-resistant strain of Staphylococcus aureus (MRSA) that colonize inside the nostrils.

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Mupirocin acts in a different way than most other antibiotics. While other antibiotics act on either the walls or the DNA of the bacteria, mupirocin works by blocking the activity of a particular enzyme known as isoleucyl-tRNA synthetase inside the bacteria. The bacteria use this enzyme to make protein, so when its effect is blocked, protein synthesis stops and they die. This different mechanism of action makes mupirocin particularly effective against bacteria that have been exposed to other antibiotics and acquired resistance to them.

The FDA approved topical mupirocin in December, 1987, and the intranasal form in October, 1995.

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Mupirocin should not be used on skin affected with serious burns. The inactive ingredient, polyethylene glycol or Miralax, used in the cream as vehicle, can be absorbed in larger quantities by such a skin, and may result in damage to kidneys. Mupirocin can also be used in infections other than those caused by the bacteria mentioned above, as decided by the dermatologist.

Prior to taking mupirocin let your health care provider know

  • If mupirocin, or any other drug, causes any type of allergy or discomfort to you.
  • If you are taking chloramphenicol (Chloromycetin), or any other prescription or over-the-counter drugs.
  • If you are planning to be pregnant, or are already pregnant, or breast feeding babies. If pregnancy occurs while you are on mupirocin, tell your doctor.
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Usage

Mupirocin is used for skin infections caused by some bacteria noted above. It is often used alone, but occasionally a second antibiotic may be given orally along with it.

How to use mupirocin

Mupirocin should be used topically, that is on the skin. The affected area should first be cleaned and allowed to dry. A small amount of the cream or ointment should be applied over it thrice a day or as advised by the dermatologist. The affected area, after application of the ointment, may be covered with a bandage.

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The medication should be used regularly for the full prescribed period of time. Lapses may provide time for the bacteria to become resistant to it.

Avoid applying medication around eyes, mouth, nose (unless using intranasal form), and on areas of seriously burnt, broken or otherwise damaged skin. Inform your dermatologist if the condition shows no improvement in 3-5 days.

How mupirocin works

Mupirocin blocks the effects of a crucial enzyme that the bacteria use to make cell proteins and form protective cell walls. This ultimately results in the death of the bacterial organism.

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Side effects

Serious
There have been no reports of serious side effects consequent upon the use of mupirocin.
Common
Initial application may lead to mild burning or stinging sensation.
Less common
Irritation, accompanied by pain, burning or stinging sensation continuing for a long period of time; topical redness or rashes with itching or dryness; nausea.

Possible interactions

Other medicaments
Mupirocin is toxic to kidneys. If taken along with other medications that are also toxic to kidneys, it may result in additive toxicity, and may damage kidneys. This will be especially true if mupirocin is being applied to a large skin area.
Herbal medicines or minerals
Liquorice, marshmallow root, oak bark, mistletoe herb should not be taken while using mupirocin. Some people use Echinacea to strengthen their immune system. However, Echinacea is not recommended for people with impaired immune system. It may in fact weaken the immune system if used too frequently or taken for too long.
Other interactions
Certain food items, alcohol, or tobacco may cause some undesirable interactions with certain medicines. Discuss these possibilities with your dermatologist, if you have been prescribed mupirocin.
The effects of mupirocin in pregnant women have not been studied adequately. But studies in animals have suggested no harmful effect of this drug on the foetus. Therefore, if your dermatologist advises so, you can take mupirocin in pregnancy.
However, there is no reliable information on how safe mupirocin is to breast feeding babies. We don't know if any amount of mupirocin, or its vehicle, absorbed from the skin reaches breast milk or not. Therefore, it would be advisable to stop breast feeding while using mupirocin.

Storage instructions

Keep the medicine in its original container; do not transfer content to some other container. Tightly close the container after use and keep away from children. Do not refrigerate. Store at room temperature, away from heat or moisture (that is, not near fireplace or in bathroom). Throw away the medication no longer required, rather than keeping it for future use.

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