Topical treatment of impetigo caused by Staphylococcus aureus and Streptococcus pyogenes (group A β-hemolytic streptococci). A drug of choice, especially when limited numbers of lesions are present. If impetigo is extensive or has not responded to topical anti-infectives, an oral anti-infective active against S. aureus and S. pyogenes (e.g., dicloxacillin, cephalosporins, erythromycin, clindamycin, fixed combination of amoxicillin and clavulanate) should be used.
Topical treatment of secondarily infected traumatic skin lesions (e.g., lacerations, sutured wounds, abrasions) that are ≤10 cm in length or ≤100 cm2 in total area and caused by susceptible S. aureus and S. pyogenes.
Has been used for topical treatment of other primary or secondary superficial skin infections, including ecthyma†, eczema†, folliculitis†, furunculosis†, atopic dermatitis†, epidermolysis bullosa†, and minor wounds†, burns†, and ulcers† caused by susceptible bacteria.
May be preferred over systemic anti-infective therapy for treatment of impetigo and other superficial skin infections caused by susceptible bacteria since it may be as effective as and is associated with fewer adverse effects than systemic therapy. However, systemic anti-infectives generally are necessary for the treatment of serious or extensive skin infections.
Nasal Carriage of Staphylococcus aureus
Temporary elimination of nasal carriage of methicillin-resistant S. aureus (MRSA; also known as oxacillin-resistant S. aureus or ORSA). Also has been used intranasally to temporarily eliminate nasal carriage of methicillin-susceptible S. aureus†.
Mupirocin ointment for intranasal use (Bactroban® Nasal) is labeled by the FDA for elimination of nasal carriage of MRSA in adult patients and health-care workers as part of a comprehensive infection control program to reduce the risk of infection among patients at high risk of MRSA infection during institutional outbreaks of infections caused by this pathogen.
Manufacturer states that data are insufficient to date to establish whether the intranasal ointment is safe and effective when used as part of an intervention program to prevent autoinfection of high-risk patients from their own nasal colonization with S. aureus and that data are insufficient to date to recommend use of the intranasal ointment for general prophylaxis of any infection in any patient population.
Has been used to eliminate nasal carriage of S. aureus in carriers at high-risk of staphylococcal infections (e.g., surgical patients, cancer patients, hemodialysis patients) in an attempt to decrease the incidence of subsequent staphylococcal infections in these patients†. Data are insufficient to support routine use of topical and/or systemic anti-infectives for eradication of MRSA colonization. However, some experts suggest that eradication of nasal carriage of S. aureus may be a reasonable strategy in certain patients with multiple documented recurrences of MRSA infection and that intranasal mupirocin may be considered for hospitalized surgical, dialysis, and nonsurgical patients at risk of infection if they are known nasal carriers of S. aureus.
Permanent eradication of nasal carriage of S, aureus following topical or systemic anti-infective therapy is unlikely; recolonization generally occurs in 30–100% of patients regardless of the anti-infective agent used.
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