Full text loading...
Chapter 36 : Mupirocin
Mupirocin is active against gram-positive cocci: it has moderate activity against gram-positive bacilli such as Listeria monocytogenes and Erysipelothrix rhusiopathiae; it is inactive against corynebacteria and Bacillus anthracis. It is inactive against Chlamydia spp. It is active against Staphylococcus aureus, whether the strains are susceptible or resistant to penicillin G, tetracyclines, erythromycin A, fusidic acid, lincomycin, chloramphenicol, or methicillin. Mupirocin has good activity against human and animal mycoplasmas. As mupirocin is highly serum protein bound, the in vitro activity is reduced in the presence of human serum. Mupirocin alters protein synthesis by blocking the incorporation of isoleucine into the peptide during synthesis. Since 1985, when mupirocin was introduced into clinical practice, two types of resistant strains have been described: those for which the MICs are between 8 and 256 µg/ml and those for which the MICs are 512 µg/ml. Extensive use of mupirocin has resulted in the emergence of resistant strains of S. aureus in the United Kingdom. Local application of mupirocin yields in situ concentrations of 20,000 mg/kg. Skin and skin structure infections are very common, but the use of topical antibiotics or other antibacterial agents is limited by a number of factors: the complexity of the anatomy of the skin, the bacterial ecology of the skin, and the nature of the microorganisms involved in these infections. Mupirocin eradicates methicillin-resistant strains of S. aureus colonizing the skin and produces an improvement in the healing of skin wounds.