Mupirocin
BACTROBAN
What it isBacterial isoleucyl-tRNA synthetase inhibitor; impetigo and nasal staphylococcal decolonization.
Why this oneIts unusual target enables topical MRSA decolonization without systemic antibiotic exposure.
What limits itRepeated or prolonged courses select resistance; reserve it for short, defined topical regimens.
FDA-approved for
- impetigo and secondary skin infection (1987)
- nasal MRSA decolonization
Off-label
- recurrent staphylococcal furunculosis decolonization
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Topical bacterial skin infection (e.g., impetigo) | adult & peds ≥2 months | Apply small amount TID for up to 10 days |
Renal Avoid where absorption of large amounts of polyethylene glycol is possible in moderate/severe renal impairment
Hepatic Undefined
Instructions
- Topical use only — not for intranasal, ophthalmic, or other mucosal use
- Apply with cotton swab or gauze; may cover with gauze dressing
- Do not apply with other lotions, creams, or ointments
- Re-evaluate if no clinical response within 3–5 days
- Not for use with IV cannulae or central IV sites
Cautions
- Severe allergic reactions (anaphylaxis, urticaria, angioedema, generalized rash)
- Eye irritation — avoid eye contact
- Discontinue on sensitization or severe local irritation
- C. difficile-associated diarrhea
- Microbial overgrowth with prolonged use
Adverse reactions
- Burning
- Stinging or pain
- Itching
Pregnancy Insufficient human data; systemic absorption through intact skin is minimal
Lactation Unknown if present in milk; minimal systemic absorption — wash treated breast/nipple before feeding
NO BOXED WARNINGS
Principal riskLittle; topical
Cost, est. cash$10–$300/month
Generic entry2013
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal irritation or hypersensitivity; systemic toxicity is minimal with correct local use.
Mechanism of action: Mupirocin ballicule
Open Mupirocin in the interactive console ↗
Memory aids: mascots and interaction avatars
