Mupirocin, fusidic acid and bacitracin: activity, action and clinical uses of three topical antibiotics

Abstract

Antibiotics applied to the skin must be formulated in a base that is nonirritant and nontoxic. They may have a narrow or fairly wide spectrum of activity but should produce no local reaction or sensitization; the commensal¯ora should not be aected unduly. Three antibiotics that have been used topically in humans and animals are fusidic acid, mupirocin and bacitracin, all of which have a narrow antibacterial spectrum. When applied to intact skin, fusidic acid penetrates more rapidly than other antibiotics. Clinically, the frequency of staphylococcal resistance to it and to mupirocin has remained low. Fusidic acid and mupirocin have been recommended for the treatment of acute staphylococcal skin lesions. However, the use of topical antibiotics for the treatment of chronic or recurring dermatitis and surgical or infected wounds may be inappropriate because of possible development of resistance and sensitization. Topical use of bacitracin may produce treatment failure and sensitization.

In vitro susceptibility testing of meticillin‐resistant and meticillin‐susceptible staphylococci to mupirocin and novobiocin

“…Mupirocin is an antimicrobial agent commonly used for topical treatment of canine bacterial skin infections, including superficial pyoderma, caused by susceptible strains of S. aureus and S. intermedius 13–15 . In humans, this drug is used to eliminate persistent nasal S. aureus carriage, which is a risk factor for S. aureus infections 16,17 …”

Surveillance of healthy cats and cats with inflammatory skin disease for colonization of the skin by methicillin‐resistant coagulase‐positive staphylococci andStaphylococcus schleiferissp.schleiferi

“…This protein is coded by the gene mecA which confers an intrinsic resistance to all β‐lactam antibiotics and their derivatives 24 . Resistance of many methicillin‐resistant (MR) strains to aminoglycosides, fluoroquinolones, fusidic acid, and mupirocin is also complete 24,25 . Antibiotic use in patients harbouring a MR strain may be a risk factor for development of resistance to other categories of antimicrobials; provocation of heterogeneous resistance in MR strains has been documented 24,26 …”

“…24 Resistance of many methicillin-resistant (MR) strains to aminoglycosides, fluoroquinolones, fusidic acid, and mupirocin is also complete. 24,25 Antibiotic use in patients harbouring a MR strain may be a risk factor for development of resistance to other categories of antimicrobials; provocation of heterogeneous resistance in MR strains has been documented. 24,26 At the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania (VHUP), we have reported an increase in the frequency of isolation of MR staphylococci.…”

Ever-increasing emergence of multi-drug resistant Staphylococcus pseudintermedius in the dog and its zoonotic potentials

“…Antibacterial bathing should be practiced 3 times per week, with 10 min contact time for better results (Murayama et al, 2011). Focal lesions can be treated with chlorexidine spray, mupirocin ointment, benzoyl peroxide gel, fusidic acid ointment or nisin (Werner and Russel, 1999). As is the case with any antimicrobial, prudent use of topical products is advised to prevent widespread resistance.…”