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INTRODUCTION

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mupirocin (myoo-peer-oh-sin)

Bactroban, Bactroban Nasal

Classification

Therapeutic: anti-infectives

Pharmacologic: monoxycarbolic acids

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Indications
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Topical: Treatment of Impetigo, Secondarily infected traumatic skin lesions (up to 10 cm in length or 100 cm2 area) caused by Staphylococcus aureus and Streptococcus pyogenes. Intranasal: Eradicates nasal colonization with methicillin-resistant S. aureus.

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Action
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Inhibits bacterial protein synthesis. Therapeutic Effects: Inhibition of bacterial growth and reproduction.

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Spectrum: Greatest activity against gram-positive organisms, including: S. aureus, Beta-hemolytic streptococci. Resolution of impetigo. Eradication of S. aureus carrier state.

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Adverse Reactions/Side Effects
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CNS: nasal only: headache. EENT: nasal only: cough, itching, pharyngitis, rhinitis, upper respiratory tract congestion. GI: nausea nasal only: altered taste. Derm: topical only: burning, itching, pain, stinging.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor any upper respiratory tract irritation, inflammation, cough, or congestion following nasal administration. Notify physician of severe or prolonged symptoms.

  • If applied topically to skin lesions, monitor any new or increased skin reactions, including localized pain, burning, itching, or stinging. Report severe or prolonged skin reactions to the physician.

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Interventions
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  • Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Use universal precautions or isolation procedures as indicated for specific patients.

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Patient/Client-Related Instruction
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  • Instruct patient with skin lesions to avoid itching or scratching the affected area. Patients should avoid contact with other individuals (e.g., other athletes) during the active phase of the infection.

  • Check that the patient and family or caregivers understand topical application procedures, adhere to the recommended dosing schedule, and wash hands thoroughly after applying the drug topically.

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Pharmacokinetics
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Absorption: Minimal systemic absorption.

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Distribution: Remains in the stratum corneum after topical use for prolonged periods of time (72 hr).

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Metabolism and Excretion: Metabolized in the skin, removed by desquamation.

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Half-life: 17–36 min.

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TIME/ACTION PROFILE (anti-infective effect)

ROUTE ONSET PEAK DURATION
nasal unknown unknown 12 hr
topical* unknown 3–5 days 72 hr

*Resolution of lesions.

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity to mupirocin or polyethylene glycol.

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Use Cautiously in: Pregnancy or lactation (safety not established); Impaired renal function; Burn patients.

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Interactions
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Drug-Drug: Nasal mupirocin should not be used concurrently with other nasal products.

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Route/Dosage
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Topical (Adults and Children ≥2 mo): Ointment: Apply 3–5 times daily for 5–14 days.

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Topical (Adults and Children ≥3 mo): Cream: Apply small amount 3 times/day for 10 days.

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