Mupirocin (mupirocin)
Also sold as: Bactroban, T-Bact, Mucocin, Mupiwash
Pregnancy
Cat B
Lactation
Safe
Schedule
H
Forms
ointment 2% (5g, 15g) +2
Indications
- Impetigo (primary bacterial skin infection)
- Secondarily infected eczema and dermatitis
- Secondarily infected wounds, abrasions, and lacerations
- MRSA nasal decolonization (nasal ointment)
- Folliculitis (minor)
Adult Dosing
Impetigo
Apply a small amount of 2% ointment/cream three times daily to affected area
5–7 days
Cover with dressing if appropriate. Crusts should be gently removed before application. If no improvement in 3–5 days, reassess for resistant organisms.
Secondarily infected eczema or wounds
Apply 2% ointment/cream two to three times daily
5–10 days
Do not use beyond 10 days — resistance develops with prolonged use.
MRSA nasal decolonization
Apply a small amount of 2% nasal ointment inside both nostrils twice daily
5 days; may repeat after 2 weeks if MRSA swab still positive
Close nostrils after application and press sides of nose together to distribute ointment. Often used pre-operatively or in healthcare workers.
Pediatric Dosing
Same adult formulation used. Limit course to 5–7 days in children. Avoid large surface area application.
Pregnancy & Lactation
Pregnancy: Category B
Topical mupirocin has negligible systemic absorption. No evidence of teratogenicity. Safe to use when indicated during pregnancy.
Lactation: Safe
Negligible systemic absorption from topical application. Do not apply to breast/nipple area to avoid infant ingestion.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Chloramphenicol (topical) | In vitro antagonism — avoid combining topical chloramphenicol with mupirocin on the same lesion | Moderate |
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Side Effects
Common
- Local burning, stinging, or itching on application
- Contact dermatitis (rare — usually to excipient polyethylene glycol in ointment)
- Erythema at application site
- Nasal ointment: nasal stinging, rhinorrhoea, headache
Serious / Discontinue If
- Mupirocin resistance (especially high-level resistance in MRSA with overuse or prolonged courses)
- Systemic absorption toxicity (with large surface area application and broken skin in young children — theoretical risk of renal impairment from polyethylene glycol base)
Contraindications
- Hypersensitivity to mupirocin or polyethylene glycol excipients
- NOT for ophthalmic use
- NOT for systemic infections (no oral or injectable formulation)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Bactroban 2% ointment 5g | GSK (Haleon) | ₹185/5g |
| T-Bact 2% ointment 5g | Cipla | ₹125/5g |
| Mucocin 2% ointment 5g | FDC Limited | ₹98/5g |
Monitoring Required
- Clinical response — improvement in lesion appearance within 3–5 days
- Swab culture if no improvement (rule out mupirocin-resistant organisms)
- MRSA screening swab 2 days after completing decolonization course
Patient Counseling Points
- Apply only a small (pea-sized) amount to the affected area — a thick layer is not necessary
- Wash hands before and after applying the ointment
- Do not use for more than 10 days without reassessment — overuse causes antibiotic resistance
- For impetigo: crusts can be gently soaked in warm water before applying to aid penetration
- Cover the area with a dry dressing after applying if advised
- Do not use in or near the eyes
- For nasal decolonization: put a small amount into each nostril and press the sides of your nose together for 1 minute to spread the ointment
- Complete the full prescribed course even if the skin looks better
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Clinically reviewed by: Dr. Neeraj Agarwal, MD (Dermatology), Diploma in Infectious Diseases
Last reviewed: 2026-04-01
References
- Bactroban SmPC — Haleon (GSK) India
- NICE CKS — Impetigo 2023
- BAD Guidelines on Impetigo 2022
- IDSA Guidelines on Skin and Soft Tissue Infections 2021