Mupirocin Ointment Can Still Be Used Like This!!
Brief introduction
Mupirocin, also known as Pseudomonas A, is an ideal skin surface antibacterial agent that was introduced to the market in 1985 by GlaxoSmithKline under the trade name "Bactroban". The FDA approved the drug for use in the United States in 1987, while China approved the production and sales of the drug by SinoSmithKline in 1993. Mopirocin is mainly used to prevent and treat skin bacterial infections caused by Gram positive cocci.
Indication
Mopirocin is mainly used to prevent and treat skin bacterial infections caused by Gram positive cocci, such as primary skin infections such as pustulosis, furuncles, folliculitis, and secondary skin infections such as eczema coinfection, ulcer coinfection, and wound coinfection. The main mechanism of the antibacterial effect of mupirocin is its inhibition of protein synthesis in bacteria.
Topical antibiotics
The raw material of Baiduobang ointment produced by well-known pharmaceutical company SinoSmithKline in China is mupirocin. This product is a new type of topical antibiotic and a metabolic substance produced in the culture medium of Pseudomonas fluorescens, namely Pseudomonas A. Mainly by reversibly binding to isoleucine transfer RNA synthase, it prevents isoleucine incorporation, terminates protein synthesis containing isoleucine in cells, and leads to bacterial death. It has an inhibitory effect at low concentrations and a bactericidal effect at high concentrations. Highly sensitive to various Gram positive cocci related to skin infections, especially Staphylococcus aureus (including drug-resistant Staphylococcus aureus) and Streptococcus pyogenes; It is also effective against Listeria monocytogenes and Erythrocytogenes; It is generally insensitive to gram-negative bacteria, but has certain antibacterial effects on some gram-negative bacteria, such as Escherichia coli, Neisseria, Haemophilus influenzae and Neisseria gonorrhoeae; Not sensitive to most anaerobic bacteria and normal skin microbiota; Low efficacy against fungi. The occurrence rate of in vitro drug resistant variants is very low. After applying this medicine to the skin, it can penetrate below the stratum corneum, but the absorption rate is very low. The binding rate with human serum protein is 95%. After absorption, it can be rapidly metabolized into the inactive substance monosporic acid, which is excreted by the kidneys. The minimum inhibitory concentration of most sensitive Staphylococcus is 0.01~0.25 mg/L, sensitive streptococcus 0.06~0.5 mg/L, and Listeria monocytogenes 8 mg/L. In vitro testing, this product is more effective under acidic conditions than under alkaline conditions. When human serum is present, its activity decreases by 1/10-1/20. At present, in clinical practice in China, mupirocin is mainly used to treat various infectious skin diseases caused by Staphylococcus aureus and Streptococcus: primary skin infections, such as pustulosis, folliculitis, and furuncle; Secondary skin infections, such as eczema, atopic dermatitis, skin ulcers, surgical wounds, small burns, and skin injuries; Other methods can also be used to prevent infection in small wounds, incisions, and other sterile lesions.
Staphylococcus aureus and Streptococcus are colonizing bacteria on the normal skin of the human body, and the nasal cavity is an important colonizing site. Staphylococcus aureus in the nasal cavity can migrate to the skin, respiratory tract, surgical incision, and other places, causing infection. Killing the endogenous Staphylococcus aureus in the nasal cavity is beneficial to reducing the incidence rate of skin, respiratory tract and surgical incision infections and preventing the occurrence of ventilator associated pneumonia.
Due to the unique anatomical structure of the nasal cavity, it is generally recommended to use topical antibacterial drugs to remove colonized bacteria. Mopirocin ointment appears to be the best choice as a commonly used medication for treating skin infections such as Staphylococcus aureus and Streptococcus. Careful medical workers may find that "this product is only for skin administration and should not be used on mucous membranes such as the nose, eyes, and mouth" when reading the instructions of mupirocin ointment. Can mupirocin ointment be applied to the nasal cavity?
It was found on the FDA website that there are two types of Mupirocin ointments in the United States. One is Mupirocin Ointment, specifically designed for skin infections, which is the domestic version of Mupirocin ointment; Another type is Mupirocin Nasal Ointment, specifically designed to remove positive bacteria such as Staphylococcus aureus colonized in the nasal cavity. Is it possible to use mupirocin ointment instead of nasal ointment in the absence of specialized nasal ointment in China? I have searched literature and found that there are already a large number of reports in China that using mupirocin ointment to apply to the nasal cavity for colonization is safe and effective. Therefore, patients with a need for colonization can try to use it.
However, as it is used beyond the instructions, the patient should be informed of the purpose of the medication during use, and if the patient has any discomfort, it should be immediately discontinued. At the same time, remind patients not to choose nasal medication on their own and to use it under the guidance of a physician.
