Efficacy of a New Cream Formulation of Mupirocin: Comparison with Oral and Topical Agents in Experimental Skin Infections

Abstract

A new cream formulation of mupirocin developed to improve patient compliance was compared with systemic and topical antibiotics commonly used to treat primary and secondary skin infections. A mouse surgical wound model infected with Staphylococcus aureus or Streptococcus pyogenes was used. Topical treatment was applied at 4 and 10 h postinfection or oral treatment at a clinically relevant dose was administered 4, 8, and 12 h postinfection; treatments were continued three times daily for a further 3 days. Mupirocin cream was significantly more effective than (P < 0.01; two of eight studies) or not significantly different from (six of eight studies) mupirocin ointment in reducing bacterial numbers. Mupirocin cream was similar in efficacy to oral flucloxacillin but significantly more effective (P < 0.001) than oral erythromycin. It was also similar in efficacy to cephalexin against S. pyogenes but superior against S. aureus (P < 0.01). Mupirocin cream had a similar efficacy to fusidic acid cream against S. aureus but was significantly superior against S. pyogenes (P < 0.01). A hamster impetigo model infected with S. aureus was also used. Topical or oral treatment was administered at 24 and 30 h postinfection (also 36 h postinfection for oral therapy) and then three times daily for a further 2 days. On day 5, mupirocin cream was significantly more effective than mupirocin ointment in one study (P < 0.01) and of similar efficacy in the other two studies. Mupirocin cream was not significantly different from fusidic acid cream or neomycin-bacitracin cream, but it was significantly superior (P < 0.01) to oral erythromycin and cephalexin. Mupirocin cream was as effective as, or superior to, oral and other topical agents commonly used for skin infections.

Enhanced Activity of Rifalazil in Combination with Levofloxacin, Linezolid, or Mupirocin against Staphylococcus aureus In Vitro

“…The MICs for levofloxacin, linezolid, and mupirocin were determined at high initial cell density, as described in Materials and Methods, both because this density (2ϫ10 8 …”

“…The spontaneous resistance frequency to linezolid is low in S. aureus (Ͻ8ϫ10 Ϫ11 ), and resistance is slow to develop [7]. Mupirocin, a drug used topically to treat S. aureus and Streptococcus pyogenes skin infections [8,9] and S. aureus nasal colonization [10], was found recently to show synergistic activity with amoxicillin-clavulanate against MSSA and MRSA in an in vitro time kill model [11]. We therefore wished to investigate its potential to interact favorably with rifalazil.…”

Development and validation of a liquid chromatographic method for in vitro mupirocin quantification in both skin layers and percutaneous penetration studies

“…Mupirocin 2% ointment applied 2 or 3 times daily has demonstrable efficacy for the treatment of both primary and secondary skin infections [8]. The most common primary skin infection is impetigo, it is highly contagious and occurs mainly in children, while secondary skin infections may occur following damage 3 by accidental trauma, surgery, and burns or as a result of superinfection of an underlying skin disease [9].…”

“…Topical ointment preparations are less acceptable to patients since ointments have high viscosities leading to difficulties in applications to skin lesions, and patients may report garment soiling from greasy residues [9]. To enhance patient acceptance and compliance could be developed new formulations such as a cream [9] or particulate drug carriers such as microparticles and nanoparticles, these carriers could protect mupirocin and release it in a controlled manner.…”

“…To enhance patient acceptance and compliance could be developed new formulations such as a cream [9] or particulate drug carriers such as microparticles and nanoparticles, these carriers could protect mupirocin and release it in a controlled manner. Acyclovir-microparticles [16] and cidofovir-microparticles [17] have already been developed for topical therapy of Herpes virus simplex.…”