MUPIROCIN

MUPIROCIN (mu-pi-ro'sin) Bactroban, Bactroban Nasal Classifications: pseudomonic acid antibiotic; Therapeutic: antibiotic Pregnancy Category: B

Availability

2% ointment; cream

Action

Topical antibacterial produced by fermentation of Pseudomonas fluorescens. Inhibits bacterial protein synthesis by binding with the bacterial transfer RNA.

Therapeutic Effect

Susceptible bacteria are Staphylococcus aureus [including methicillin-resistant (MRSA) and beta-lactamase-producing strains] and other Staphylococcus and Streptococcus pyogenes.

Uses

Impetigo due to Staphylococcus aureus, beta-hemolytic Streptococci, and Streptococcus pyogenes; nasal carriage of S. aureus.

Unlabeled Uses

Superficial skin infections; burns.

Contraindications

Hypersensitivity to any of its components and for ophthalmic use; lactation (do not apply to breast); children <12 y (intranasal form); moderate to severe renal impairment.

Cautious Use

Pregnancy (category B), lactation.

Route & Dosage

Impetigo Adult/Child: Topical Apply to affected area t.i.d., if no response in 3–5 d, reevaluate (usually continue for 1–2 wk) Elimination of Staphylococcal Nasal Carriage Child: Intranasal Apply intranasally b.i.d. to q.i.d. for 5–14 d

Administration

Topical

• Apply thin layer of medication to affected area.
• Cover area being treated with a gauze dressing if desired.

Adverse Effects (≥1%)

Skin: Burning, stinging, pain, pruritus, rash, erythema, dry skin, tenderness, swelling. Special Senses: Intranasal, local stinging, soreness, dry skin, pruritus.

Interactions

Drug: Incompatible with salicylic acid 2%; do not mix in hydrophilic vehicles (e.g., Aquaphor) or coal tar solutions; chloramphenicol may interfere with bactericidal action of mupirocin.

Pharmacokinetics

Absorption: Not systemically absorbed.

Nursing Implications

Assessment & Drug Effects

• Watch for signs and symptoms of superinfection (see Appendix F). Prolonged or repeated therapy may result in superinfection by nonsusceptible organisms.
• Reevaluate drug use if patient does not show clinical response within 3–5 d.
• Discontinue the drug and notify physician if signs of contact dermatitis develop or if exudate production increases.

Patient & Family Education

• Discontinue drug and contact physician if a sensitivity reaction or chemical irritation occurs (e.g., increased redness, itching, burning).

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Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug