mupirocin calcium: clinical use

Prescribing considerations

• Confirm that the nasal formulation is appropriate; it is licensed for eliminating nasal staphylococcal carriage.
• Consider local susceptibility information because acquired mupirocin resistance can occur.
• Avoid prolonged or repeated exposure where possible because non-susceptible organisms may overgrow.
• Do not administer alongside other intranasal ointments or active substances unless compatibility is established.

Contraindications and cautions

• Hypersensitivity to mupirocin calcium, mupirocin or an excipient.
• Do not treat infants because of the risk of tracheal aspiration.
• Not for ophthalmic use.

Monitoring

• Stop and reassess if sensitisation or severe local irritation occurs.
• Investigate significant or persistent diarrhoea or abdominal cramps.
• Microbiological testing may be used to verify clearance.
• Consider susceptibility testing or specialist microbiology advice where resistance is suspected.

Clinical pharmacology

Mupirocin inhibits bacterial isoleucyl-transfer RNA synthetase. Systemic absorption after local application is very low; absorbed material is rapidly converted to inactive monic acid and mainly excreted in urine.

Formulation and product differences

• This is an off-white nasal ointment in a white-soft-paraffin base containing bis-diglyceryl polyacyladipate-2.
• It is specifically formulated for intranasal use and should not be mixed with other medicinal products.
• Opened contents have a limited in-use shelf life; follow pack instructions and discard remaining product after treatment.

Nasal ointment

Route: Nasal

Strengths: 2%