mupirocin: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
mupirocin: clinical details
Prescribing considerations
- Confirm that the indication and site match the selected skin, cream or nasal formulation.
- Reassess if infection worsens or does not respond as expected; consider susceptibility and an alternative diagnosis.
- Avoid unnecessary or prolonged exposure because non-susceptible organisms and mupirocin-resistant staphylococci may emerge.
- The selected cream is licensed from one year of age and the selected skin ointment from four weeks; check the individual product before prescribing.
Contraindications and cautions
- Hypersensitivity to mupirocin or a formulation excipient.
- Skin cream and skin ointment are unsuitable for intranasal or ophthalmic use.
- Avoid polyethylene-glycol-based skin ointment where substantial absorption from large open or damaged areas is possible, particularly with moderate or severe renal impairment.
- Do not use the selected skin ointment with cannulae or at central venous cannulation sites.
Monitoring
- Monitor clinical response and local irritation or sensitisation.
- Consider overgrowth of non-susceptible organisms if symptoms change or persist.
- Stop treatment and assess substantial or persistent diarrhoea or abdominal cramps.
Clinical pharmacology
Mupirocin selectively inhibits bacterial isoleucyl-transfer RNA synthetase and arrests protein synthesis. Systemic absorption after topical use is generally very low; absorbed mupirocin is rapidly converted to monic acid and mainly eliminated in urine.
Formulation and product differences
- Skin ointment: intended for specified primary bacterial skin infections; the selected product has a polyethylene glycol base.
- Cream: intended for secondarily infected minor traumatic skin lesions and contains cetyl alcohol, stearyl alcohol and benzyl alcohol, which can cause local reactions.
- Nasal ointment: paraffin-based and specifically formulated to eradicate staphylococcal nasal carriage; it must not be used in the eyes.
mupirocin preparations and strengths
Cream
Route: Cutaneous
Strengths: 2%
Ointment
Route: Cutaneous
Strengths: 20 mg/g, 2%, 2% w/w
Nasal ointment
Route: Nasal
mupirocin interactions
No clinically significant systemic medicine interactions have been identified, although formal interaction data are limited.
Other topical preparations at the same site
Mixing products can dilute mupirocin, reduce antibacterial activity and affect formulation stability.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.