Active Ingredient Profile

Bactroban contains the active ingredient mupirocin. Mupirocin is an antibacterial agent derived from the fermentation of the organism Pseudomonas fluorescens. It works by interfering with the bacterial protein synthesis, ensuring effective treatment of skin infections.

Indications for Use

Bactroban is indicated for the treatment of primary skin infections such as impetigo, folliculitis, and furunculosis. It is also effective in secondary skin infections like infected cuts, eczema, and dermatitis. The ointment form may be prescribed for nasal carriage of Staphylococcus aureus.

Proper Administration Guidelines

Apply Bactroban to the affected area of the skin. Clean and dry the area before application. Use a small amount of the ointment or cream, usually three times a day. For nasal formulations, insert a small amount into each nostril twice daily. Avoid large surface areas to prevent systemic absorption.

Storage Requirements

Store Bactroban at a temperature below 25°C (77°F). Do not freeze the medication. Ensure the tube is tightly closed to avoid contamination. Keep out of reach of children and away from excessive moisture and heat.

Mechanism of Action

Mupirocin inhibits bacterial protein synthesis by reversibly binding to bacterial isoleucyl-tRNA synthetase. This action prevents the incorporation of isoleucine into prokaryotic proteins, thus inhibiting bacterial growth. It exhibits minimal cross-resistance with other antibiotics, making it a valuable treatment option.

Contraindications Overview

Bactroban is contraindicated in individuals with a known hypersensitivity to mupirocin or any of its excipients. It should not be used in eyes, for intravenous therapy, or in patients with large open wounds due to possible systemic absorption of polyethylene glycol present in the ointment base.

Reported Side Effects

Common side effects of Bactroban include localized irritation, itching, and redness. Rarely, patients may experience contact dermatitis, swelling, or increased local pain. Systemic side effects are uncommon, given the topical nature of the drug, but should be reported promptly if observed.

Drug Interaction Possibilities

Bactroban has minimal systemic absorption, thus reducing the potential for drug interactions. However, avoid concurrent use with other topical products on the same area if possible. No significant interactions with systemic medications have been documented.

Dosage Considerations

For skin infections, a small amount should be applied to the affected area up to three times a day. For nasal carriage of Staphylococcus aureus, a pea-sized amount is recommended for each nostril twice daily. Dosage duration typically ranges from 5 to 14 days, depending on infection severity and clinical response.

Pregnancy and Nursing

The safety of Bactroban during pregnancy and lactation has not been fully established. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. In nursing mothers, caution is advised, and application near the breast area should be avoided to prevent ingestion by the infant.

Pediatric and Geriatric Use

Bactroban can be used in pediatric patients older than two months for skin infections. In geriatric patients, no significant differences in safety or efficacy have been observed, though increased sensitivity in some older individuals cannot be ruled out.

Availability and Packaging

Bactroban is available as a 2% topical ointment, 2% cream, and 2% nasal ointment. The topical ointment is provided in tubes of 15 grams, while the cream is available in tubes of 15 grams and 30 grams. The nasal ointment comes in 1-gram individual-use tubes.

Pharmacokinetic Properties

Mupirocin is minimally absorbed through intact skin. When applied topically, serum levels are typically undetectable. Any absorbed mupirocin is rapidly metabolized to an inactive monic acid, which is primarily excreted by the kidneys.

Special Populations

In patients with renal impairment, caution should be exercised due to the potential accumulation of the inactive metabolite monic acid when using large quantities or if systemic absorption occurs. No specific adjustments are required for hepatic impairment.

Microbial Spectrum

Bactroban is specifically effective against gram-positive bacteria, including Staphylococcus aureus (including MRSA), Staphylococcus epidermidis, and Streptococcus pyogenes. It has limited activity against gram-negative bacteria and is not effective against fungal or viral infections.