Bactroban

Common Uses

Bactroban is primarily prescribed to treat skin infections caused by bacteria. It is available in different forms depending on the location and type of infection:

• Impetigo: The ointment form is used to treat impetigo, a contagious skin condition that often affects children and causes red sores or blisters.
• Infected Skin Wounds: The cream form is used to treat small cuts, abrasions, or surgical wounds that have become infected with specific types of bacteria.
• Nasal Colonization: A specific nasal formulation is used to eliminate Staphylococcus aureus bacteria, including methicillin-resistant strains (MRSA), from the nostrils. This is often done to help prevent the spread of these bacteria to other people or other parts of the body.

This medication works by stopping the growth of certain bacteria. It is only effective against bacterial infections and will not work for infections caused by viruses or fungi.

Mechanism of Action

Bactroban contains the active ingredient mupirocin. It works by interfering with the way bacteria produce the essential proteins they need to survive and multiply. Specifically, the medication binds to an enzyme called isoleucyl transfer-RNA synthetase within the bacterial cell. Without this enzyme, the bacteria cannot build new proteins, which prevents them from growing and spreading.

Targeted Bacteria

This medication is effective against several types of bacteria that commonly cause skin infections, including:

• Staphylococcus aureus (including methicillin-resistant strains, or MRSA)
• Streptococcus pyogenes

By stopping the growth of these bacteria at the site of application, the medication allows the body's immune system to eliminate the remaining infection. Because it specifically targets bacterial protein production, it is only effective against bacterial infections. It does not work for infections caused by viruses, such as the common cold, or for fungal infections.

Common Side Effects

The most frequent side effects of Bactroban occur at the site where the medication is applied. These may include:

• Burning or stinging
• Itching
• Pain
• Redness
• Dryness
• Swelling or tenderness

When using the nasal formulation, some people may experience headaches, a runny or stuffy nose, a sore throat, or a change in their sense of taste.

Serious Side Effects

While rare, some serious side effects can occur. Seek medical attention immediately if you experience:

• Signs of an allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
• Severe skin reactions, including blistering, peeling, or a widespread red rash.
• Severe stomach pain and watery or bloody diarrhea, which may occur days or weeks after treatment ends.
• Extreme irritation or new sores in the area where the medicine was applied.

Allergic Reactions

Severe allergic reactions, including swelling, hives, and difficulty breathing, have been reported rarely. If a skin reaction or signs of hypersensitivity occur, treatment should be stopped, the product washed off, and a healthcare provider consulted.

Eye and Mucosal Contact

Bactroban is for external use only. It should not be applied to the eyes. If accidental contact occurs, the eyes should be rinsed thoroughly with water. The ointment and cream formulations are not intended for use inside the nose.

Kidney Concerns and Polyethylene Glycol

Bactroban ointment contains polyethylene glycol (PEG). This ingredient can be absorbed through open wounds or damaged skin. Because absorbed PEG is eliminated by the kidneys, the ointment should be used with caution in patients with known or suspected kidney impairment, especially if applied to large areas of broken skin.

Risk of Secondary Infection

As with other antibiotics, prolonged use of this medication may result in the overgrowth of nonsusceptible organisms, such as fungi. If the infection does not improve or worsens, further medical evaluation may be necessary.

Diarrhea Risks

Although rare with topical antibiotics, Clostridioides difficile-associated diarrhea (CDAD) has been reported with the use of nearly all antibacterial agents. This condition can range from mild diarrhea to fatal colitis.

Pregnancy

There is limited information regarding the use of Bactroban in pregnant women. Animal studies have not shown evidence of harm to the developing fetus when mupirocin was administered at high doses. However, because human data is lacking, healthcare providers typically recommend using this medication during pregnancy only if the potential benefits outweigh the potential risks.

Breastfeeding

It is unknown if mupirocin passes into human breast milk. If you are using this medication while breastfeeding, consider the following precautions:

• Consult with a healthcare provider to discuss the risks and benefits.
• If applying the medication to the breast or nipple, wash the area thoroughly before nursing to ensure the infant does not swallow the medicine.

Available Forms

Bactroban is supplied in the following topical preparations:

• Ointment: A formulation for application to the skin.
• Cream: A formulation for application to the skin.
• Nasal Ointment: A specific formulation designed for use inside the nostrils.

These products are intended for external use only. The skin ointment and cream should not be used in the eyes or on mucosal surfaces unless specifically directed, and the nasal ointment is intended only for intranasal application.

FDA Approval and Indications

Bactroban (mupirocin) is approved by the U.S. Food and Drug Administration (FDA) for the topical treatment of impetigo, a contagious skin infection caused by specific bacteria such as Staphylococcus aureus and Streptococcus pyogenes. The cream formulation is also approved for the treatment of secondarily infected traumatic skin lesions due to susceptible strains of bacteria.

The nasal ointment formulation is specifically FDA-approved for the eradication of nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) in adult patients and healthcare workers. This is intended to help reduce the risk of infection among patients at high risk of MRSA during institutional outbreaks.

Safety and Regulatory Status

Bactroban does not currently have any boxed warnings or Risk Evaluation and Mitigation Strategies (REMS) requirements. However, the FDA-approved labeling includes several important safety considerations:

• Not for Ophthalmic Use: Bactroban is not approved for use in the eyes.
• Hypersensitivity: The medication should be discontinued if a sensitization reaction or severe local irritation occurs.
• Antibiotic Resistance: As with other antibacterial products, the FDA warns that prolonged use may result in the overgrowth of nonsusceptible organisms, including fungi.
• Formulation Differences: The topical ointment and nasal ointment are distinct products with different indications and should only be used as directed for their specific approved sites.

Uses for Bactroban Cream

Bactroban cream contains the active ingredient mupirocin calcium. It is specifically indicated for the treatment of secondarily infected traumatic skin lesions. These include minor lacerations, sutured wounds, and abrasions that have become infected by susceptible strains of bacteria, such as Staphylococcus aureus and Streptococcus pyogenes.

Application Instructions

To use Bactroban cream correctly, follow these general steps:

• Wash your hands thoroughly before and after application.
• Clean and dry the affected skin area before applying the medication.
• Apply a small amount of the cream to the affected area, typically three times a day.
• The treated area may be covered with a sterile gauze dressing if necessary.

Treatment is usually continued for 10 days. It is important to use the medication for the full length of time prescribed by a healthcare provider, even if the skin appears to be healing, to prevent the infection from returning.

Precautions and Warnings

Bactroban cream is for external use on the skin only. It should not be used in the eyes or on mucosal surfaces like the inside of the nose. If the infection does not show improvement within 3 to 5 days, or if the condition worsens, consult a healthcare professional. If a skin reaction or severe irritation occurs, stop using the cream and rinse the area thoroughly with water.