Mupirocin

Mupirocin is a topical antibiotic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Mupirocin is used for bacterial infections of small areas of skin, including:

• Impetigo — the crusted, honey-coloured sores common in children, often around the nose and mouth
• Infected small cuts, scratches, abrasions and minor wounds
• Folliculitis — infected hair follicles, and very small boils
• Secondarily infected skin conditions — such as eczema or insect bites that have become infected, when a doctor advises

A separate nasal ointment is used, on a doctor's instruction, to clear Staphylococcus aureus carried inside the nose. Mupirocin treats bacterial infections only — it does not work on fungal or viral skin problems.

Apply a small amount of Mupirocin to the affected area 2–3 times daily, or as your doctor advises.

• Wash your hands before and after; gently clean and dry the area first
• Apply a thin layer with a clean fingertip, cotton bud or gauze; the area may be covered with a light gauze dressing if the doctor agrees
• The usual course is 5–10 days — do not use it for longer than advised
• Use it on small areas of skin only; it is not meant for large wounds or burns
• Children should use it under a doctor's direction

If the infection shows no improvement within 3–5 days, go back to your doctor. Complete the prescribed course even if the skin looks better earlier, so the infection does not return.

Mupirocin is generally well tolerated. Possible side effects, mostly limited to the application site, include:

• Burning or stinging just after application
• Itching
• Redness or dryness of the skin
• Rarely — allergic contact dermatitis with swelling, blistering or a spreading rash

Mild burning usually fades within minutes. Stop using the ointment and contact your doctor if irritation is severe or worsening, if the treated area becomes more swollen and painful, or if you develop any sign of a general allergic reaction such as facial swelling or difficulty breathing after using Mupirocin.

• Use short courses on small areas only. Long or repeated use encourages resistant bacteria, which makes this valuable antibiotic stop working — never use it casually on every spot or graze
• Do not apply to large open wounds or burns — the ointment base (polyethylene glycol) can be absorbed through damaged skin and may harm the kidneys, especially in people with kidney disease
• Avoid the eyes and the inside of the nose (unless you have been given the specific nasal preparation); rinse with water if contact occurs
• Do not use it at sites where tubes or cannulas enter the skin
• It treats bacterial infection only — see a doctor if the problem could be fungal, viral or something else
• If the infection spreads, or fever develops, see a doctor — oral antibiotics may be needed

Because Mupirocin acts on the skin surface and almost none enters the bloodstream, significant interactions with tablets, capsules or injections are unlikely. Practical points:

• Other creams and ointments — do not mix or layer other skin products on the same spot at the same time; they can dilute the antibiotic and reduce its effect. Leave a gap or use them at different times as your doctor advises
• Other topical antibiotics or antiseptics — combining them is rarely useful and should only be done on medical advice

As always, tell your doctor or pharmacist about every medicine and skin product you use before starting Mupirocin.

Do not use Mupirocin if you:

• Are allergic to mupirocin or any other ingredient of the ointment or cream, including the polyethylene glycol base
• Have previously had a severe skin or allergic reaction to this medicine

Do not apply it to the eyes, to large or deep wounds, to severe burns, or through medical devices entering the skin. Use with caution in moderate to severe kidney disease when larger raw areas are involved, because the ointment base can be absorbed. If you are unsure whether Mupirocin is suitable for your wound, ask your doctor or pharmacist first.

Pregnancy: Almost no mupirocin is absorbed through intact skin, and no harm to the baby is expected from treating small areas. Even so, use Mupirocin during pregnancy only when your doctor considers it needed, and exactly as directed.

Breastfeeding: Skin use is considered compatible with breastfeeding. If the infection being treated is on or near the nipple, do not breastfeed from that side until you have asked your doctor — the area must be washed thoroughly before feeding so the baby does not swallow the ointment, and the doctor may suggest how to time applications between feeds.

Store Mupirocin below 30°C in a cool, dry place, away from direct sunlight. Do not freeze.

• Keep the tube tightly closed when not in use
• Keep out of the reach and sight of children
• Do not use after the expiry date printed on the tube or carton
• Discard the tube within the period stated on the label after first opening, and do not keep leftover ointment for future infections without a doctor's advice