Mupirocin is a natural crotonic acid derivative extracted from Pseudomonas fluorescens. Mupirocin inhibits bacterial protein synthesis by specific reversible binding to bacterial isoleucyl tRNA synthase. With excellent activity against gram-positive staphylococci and streptococci, it is primarily used for the treatment of primary and secondary skin disorders, nasal infections, and wound healing.
Mupirocin (pseudomonic acid A, or Bactroban or Century) is an bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।" data-rx-term="antibiotic" data-rx-definition="An antibiotic is a medicine used to treat bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।">antibiotic originally isolated from Pseudomonas fluorescens. It is used topically and is primarily effective against Gram-positive bacteria. Mupirocin is bacteriostatic at low concentrations and bactericidal at high concentrations. Mupirocin has a unique mechanism of action, which is selective binding to bacterial isoleucyl-tRNA synthetase, which halts the incorporation of isoleucine into bacterial proteins. Because this mechanism of action is not shared with any other antibiotic, mupirocin has few problems with antibiotic cross-resistance.
Mechanism of Action of Mupirocin
Mupirocin specifically and reversibly binds to bacterial isoleucyl transfer-RNA (tRNA) synthetase, which is an enzyme that promotes the conversion of isoleucine and tRNA to isoleucyl-tRNA. The inhibition of this enzyme subsequently leads to the inhibition of the bacterial protein and RNA synthesis. Mupirocin is bacteriostatic at lower concentrations but it exerts bactericidal effects with prolonged exposure, killing 90-99% of susceptible bacteria over a 24 hour period. Compounds that inhibit the synthesis of proteins. They are usually ANTI-BACTERIAL AGENTS or toxins. Mechanism of the action of inhibition includes the interruption of peptide-chain elongation, blocking the A site of ribosomes, the misreading of the genetic code or the prevention of the attachment of oligosaccharide side chains to glycoproteins.
Mupirocin is reported to be active against susceptible aerobic gram-positive cocci, such as Staphylococcus aureus_, Staphylococcus epidermidis, and other beta-hemolytic streptococci Streptococcus pyogenes. It mediates its antibacterial activity by inhibiting bacterial protein synthesis and the formation of bacterial proteins essential for survival. The minimum bactericidal concentration (MBC) against relevant pathogens is generally eight-fold to thirty-fold higher than the minimum inhibitory concentration (MIC). In one clinical study investigating the therapeutic effectiveness of topical mupirocin in impetigo, the therapeutic response rate was about 94 to 98% after one week following the end of therapy.[label] In clinical studies of patients with primary and secondary skin infections, both elimination of the bacterial pathogen and clinical cure or improvement have been demonstrated in over 90% of patients receiving topical mupirocin. Mupirocin resistance as high as 81% have been reported previously. Resistance to mupirocin, which occurs more frequently in methicillin-resistant than methicillin-susceptible staphylococci, may occur with the production of a modified isoleucyl-tRNA synthetase, or the acquisition of, by genetic transfer, a plasmid mediating a new isoleucyl-tRNA synthetase.
Indications of Mupirocin
- Indicated for the treatment of impetigo and secondary skin infections, leading to traumatic skin lesions, due to Staphylococcus aureus and Streptococcus pyogenes.
- Impetigo
- Impetigo caused by Staphylococcus aureus
- Impetigo caused by streptococcus pyogenes
- Secondary infection Skin infection
- Skin and Structure Infection
- Secondary Cutaneous Bacterial Infections
- Nasal Carriage of Staphylococcus aureus
- Paronychia
- Staphylococcus aureus colonization of the nasal passage
- Mupirocin is used as a topical treatment for bacterial skin infections, for example, furuncle, impetigo, open wounds, which are typically due to infection by Staphylococcus aureus or Streptococcus pyogenes. It is also useful in the treatment of superficial methicillin-resistant Staphylococcus aureus (MRSA) infections.[rx] Mupirocin is inactive for most anaerobic bacteria, mycobacteria, mycoplasma, chlamydia, yeast, and fungi.[rx]
- Intranasal mupirocin before surgery is effective for the prevention of postoperative wound infection with Staphylococcus aureus and preventative intranasal or catheter-site treatment is effective for reducing the risk of catheter site infection in persons treated with chronic peritoneal dialysis.[rx]
Contraindications of Mupirocin
- No Disease Contraindications
- Data Information not available
Dosage of Mupirocin
Strengths: 2%
Secondary Cutaneous Bacterial Infections
- Following the application of mupirocin ointment – 2% to a 400 cm2 area on the back of 23 healthy volunteers once daily for 7 days, the mean (range) cumulative urinary excretion of monic acid over 24 hrs following the last administration was 1.25% (0.2% to 3.0%) of the administered dose of mupirocin.
- Topical cream – Apply a small amount to the affected area 3 times a day for 10 days.
Nasal Carriage of Staphylococcus aureus
- Nasal ointment – Apply about one-half of the tube contents into 1 nostril and the other half into the other nostril twice a day (morning and evening).
Duration of therapy: 5 days
Impetigo
- Topical ointment – Apply a small amount to the affected area 3 times a day.
Secondary Cutaneous Bacterial Infections for 3 months or older
- Topical cream – Apply a small amount to the affected area 3 times a day for 10 days.
Pediatric Dose
Nasal Carriage of Staphylococcus aureus for 12 years or older
- Nasal ointment – Apply about one-half of the tube contents into 1 nostril and the other half into the other nostril twice a day (morning and evening).
- Duration of therapy – 5 days
Impetigo
2 months or older
- Topical ointment – Apply a small amount to the affected area 3 times a day.
Side Effects of Mupirocin
Most common
- Burning, stinging, or pain on the application site
- Dry skin
- skin burning, itching, pain, rash, redness, stinging, or swelling
- Signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- Diarrhea (watery and severe; may also be bloody)
Common
- Blistering, crusting, irritation, itching, or reddening of the skin
- canker sores
- cracked, dry, scaly skin
- pain, swelling, tenderness, warmth on the skin
- sores, ulcers, or white spots on the lips or tongue or inside the mouth
Rare
- Abdominal or stomach pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">tenderness
- cough
- difficulty with swallowing
- dizziness
- fast heartbeat
- fever
- hives or welts, itching, or skin rash
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- redness of the skin
- severe abdominal or stomach cramps and pain
- tightness in the chest
- unusual tiredness or weakness
- watery and severe diarrhea, which may also be bloody
Drug Interactions of Mupirocin
No drug interactions have been identified with the use of topical mupirocin. or data information not available. If Possible
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
Pregnancy Category of Mupirocin
Pregnancy
The safety of this medication for the treatment of infections during pregnancy is unknown. If you are or may be pregnant, talk to your doctor about the benefits and risks of using mupirocin.
Lactation
If you are breast-feeding, talk to your doctor about the benefits and risks of using this medication. If you are using this medication to treat a cracked nipple, your doctor may advise you to use a breast pump to pump the milk from the affected breast while you are using this medicine.
References
- https://www.drugbank.ca/legal/terms_of_use
- http://www.drugbank.ca/drugs/DB00410
- http://www.drugbank.ca/drugs/DB00410
- https://www.drugs.com/mtm/mupirocin-nasal.html
- https://www.fda.gov/about-fda/about-website/website-policies#linking
- https://dailymed.nlm.nih.gov/dailymed/browse-drug-classes.cfm
- https://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/ucm162549.htm
- http://www.hmdb.ca/metabolites/HMDB0014554
- https://www.cancer.gov/policies/copyright-reuse
- https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?
- https://chem.nlm.nih.gov/chemidplus/sid/0012650690
- https://chem.sis.nlm.nih.gov/chemidplus/
