Mupiderm Composition, Use, Dose, Side Effect

Mupiderm is a medicated cream. It is used to treat dermal bacterial infection. Mupiderm is a product of Aquatix Pharmaceuticals Limited Lagos, Nigeria but Manufactured by Yash Medicare Pvt. Ltd. India.

Mupiderm cream

Composition Of Mupiderm Cream

Mupirocin USP 2% w/w

Water Soluble Ointment base q.s.

Indication Of Mupiderm Cream

Mupiderm is indicated for the topical treatment of the following infections:

Primary skin infection: Impetigo, folliculitis, furunculosis and ecthyma.

Secondary skin infection: Infected dermatitis, infected eczema, infected traumatic lesions e.g., abrasions, insect bites, minor wounds and minor burns.

Prophylaxis: It may be used to avoid bacterial contamination of small wounds, incisions and other clean lesions and to prevent infection of abrasions and small cuts and wounds.

Action

Mupirocin is a new antibiotic produced through fermentation by Pseudomonas fluorescens. Mupirocin inhibits isoleucyl transfer-RNA synthetase, thereby arresting bacterial protein synthesis. Due to this particular mode of action and its unique chemical structure, mupirocin does not show any cross resistance with other clinically available antibiotics.

Mupirocin shows little risk of selection of resistant bacteria if used as prescribed. Mupirocin has bacteriostatic properties at minimum inhibitory concentrations and bactericidal properties at the higher concentrations reached when applied locally. Following intravenous or oral administration, mupirocin is rapidly metabolized to inactive monic acid.

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Activity

Mupirocin ointment shows in vivo activity against Staphylococcus aureus (including methicillin-resistant strains), S. Epidermidis and beta-haemolytic Streptococcus species. The in vitro spectrum of activity includes the following bacteria:

Aerobic Gram-positive:

-Staphylococcus aureus (including beta-lactamase producing strains and methicillin resistant strains)

-Staphylococcus epidermidis

-Other coagulase negative Staphylococci (including methicillin resistant strains)

-Streptococcus species.

-Anaerobic Gram-negative:

-Haemophilus Influenzae

-Proteus vulgaris

-Neisseria gonorrhoeae

-Neisseria meningitidis

-Branhamella catarrhalis

-Pasteurella multocida

-Proteus mirabilis

-Enterobacter cloacae

-Enterobacter aerogenes

-Citrobacter freundii

-Bordetella pertussis

Susceptibility: Susceptible to

-Staphylococcus aureus**

-Staphylococcus epidermidis**

-Coagulase-negative staphylococci**

-Streptococcus species

-Neisseria gonorrhoeae

-Neisseria meningitidis

-Moraxella catarrhalis

-Pasteurella multocida

-Haemophilus influenzae

*Clinical efficacy has been demonstrated for susceptible isolates in approved clinical indications.

Range of resistance: 0-23%

Insusceptibility: Insusceptible to Corynebacterium species, enterobacteriaceae, gram negative non-fermenting rods, micrococcus species and Anaerobes.

Cross resistance: Mupirocin does not demonstrate cross resistance with any other known antimicrobial.

Resistance mechanisms: Low-level resistance in staphylococci (MICs 8-256 mcg/ml) has been shown to be due to changes in the native isoleucyl tRNA synthetase enzyme. High level resistance in staphylococci (MICs > 512 mcg/ml) has been shown to be due to a distinct, plasmid encoded isoleucyl tRNA synthetase enzyme. Intrinsic resistance in Gram negative organisms such as the Enterobacteriaceae could be due to poor penetration into the bacterial cell.

Pharmacokinetics

Mupirocin is poorly absorbed through intact human skin. However, if it is absorbed (e.g. through broken/diseased skin) or it is given systemically, it is metabolized to the microbiologically inactive metabolite monic acid by de-esterification which is rapidly excreted in urine. Mupirocin is rapidly eliminated from the body by metabolism to its inactive metabolite monic acid which is excreted mainly by the kidney (90%). It is 95% -97% bound to plasma proteins.

Contraindications

Mupirocin is usually well tolerated but local reactions such as burning, stinging and itching may occur after the application of Mupirocin to the skin. Care is also required in patients with renal impairment.

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Mupirocin ointment should not be used on patients with a history of hypersensitivity to any of its constituents.

Special Warnings And Special Precautions

For patients with renal impairment: No restrictions unless the condition being treated could lead to absorption of polyethylene glycol and there is evidence of moderate or severe renal impairment. Polyethylene glycol can be absorbed from open wounds and damaged skin and is excreted by the kidneys.

In common with other polyethylene glycol-based ointments, mupirocin ointment should not be used in conditions where absorption of large quantities of polyethylene glycol is possible; the excretion of polyethylene glycol may be impaired and could lead to nephrotoxicity and severe metabolic disturbances.

This mupirocin ointment formulation is not suitable for:

-Ophthalmic use

-Intranasal use (in neonates or infants).

-Use in conjunction with cannulae.

-At the site of central venous cannulation.

For intranasal use, a separate presentation, mupirocin nasal, is available. Avoid contact with eyes. If contaminated, the eyes should be thoroughly irrigated with water, until the ointment residues have been removed.

As with other antibacterial products, prolonged use may result in overgrowth of non-susceptible organisms, such as fungi. Treatment with Mupirocin should be avoided, if sensitivity or chemical reaction occurs with the use. Appropriate secondary therapy for the infection must be initiated.

Drug Interactions

No drug interactions have been reported.

Use In Pregnancy And Lactation

Adequate human data on use during pregnancy are not available. However, animal studies have not identified any risk to pregnancy or embryo-fetal development. This drug should be used during pregnancy only if clearly needed.

Adequate human and animal data on use during lactation are not available. It is not known whether this drug is excreted in human milk. Caution should be exercised while administering to a nursing woman.

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Adverse Effects Of Mupiderm

Headache, nausea, burning, stinging, pain, pruritus, rash, cellulitis, dry skin, erythema, pain or bleeding secondary to eczema, secondary wound infection, swelling, tenderness and urticaria are some of the adverse reactions which may occur occasionally with use.

Immune system disorders:

Very rare: Systemic allergic reactions have been reported with mupirocin ointment.

Skin and subcutaneous system disorders:

Common: Burning localized to the area of application.

Uncommon: Itching, erythema, stinging and dryness localized to the area of application.

Uncommon: Cutaneous sensitization reactions to mupirocin or the ointment base.

Overdosage

Application of too much Mupirocin ointment is unlikely to cause any serious problems.

Mupirocin ointment contains polyethylene glycol, which could cause problems in case of overdose in rare cases.

However, if a significant amount is absorbed, which might happen with severe burns or large open wounds, polyethylene toxicity could result, especially in people with kidney problems.