Topical antibiotic (pseudomonic acid) Pregnancy: Animal reproduction studies revealed no evidence of harm to the foetus; as there is no clinical experience of use during pregnancy, it should only be used in pregnancy when the potential benefits outweigh the possible risks. Breast-feeding: it is unknown whether mupirocin is excreted in human milk — if a cracked nipple is treated, it should be thoroughly washed prior to breast-feeding.

Mupirocin 2% Ointment

Brand names: Bactroban (2% ointment, 2% nasal ointment)

Mupirocin 2% ointment is a topical antibacterial used for impetigo and other localised skin infections, and for nasal decolonisation of meticillin-resistant Staphylococcus aureus (MRSA).

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply to the affected area up to three times a day for up to 10 days

Route: Topical (cutaneous)

Frequency: Up to three times daily; maximum duration 10 days

UK SPC gives the same posology for adults (including the elderly) and the paediatric population. The area may be covered with a dressing or occluded if desired. Do not mix with other preparations — risk of dilution, reduced antibacterial activity and potential loss of stability of the mupirocin in the ointment. This formulation is not suitable for ophthalmic use, intranasal use (in neonates or infants), use in conjunction with cannulae, or at the site of central venous cannulation. Avoid contact with the eyes; if contaminated, irrigate thoroughly with water until ointment residues have been removed. Prolonged use may result in overgrowth of non-susceptible organisms. US labelling is consistent: 'A small amount ... applied to the affected area 3 times daily'; patients not showing a clinical response within 3 to 5 days should be re-evaluated.

Dose adjustments

Renal

Polyethylene glycol can be absorbed from open wounds and damaged skin and is excreted by the kidneys; this ointment should not be used where absorption of large quantities of polyethylene glycol is possible, especially if there is evidence of moderate or severe renal impairment (SPC §4.4). No numeric dose adjustment is given.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION A small amount of Mupirocin Ointment USP, 2% should be applied to the affected area 3 times daily. The area treated may be covered with a gauze dressing if desired. Patients not showing a clinical response within 3 to 5 days should be re-evaluated.

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-12-13. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Not suitable for ophthalmic use
Not suitable for intranasal use (this ointment formulation)

Side effects

Burning localised to the area of application (common)
Itching, erythema, stinging and dryness localised to the area of application (uncommon)
Cutaneous sensitisation reactions to mupirocin or the ointment base (uncommon)
Systemic allergic reactions including anaphylaxis, generalised rash, urticaria and angioedema (very rare)
Pseudomembranous colitis has been reported with antibacterials — less likely with topical mupirocin, but stop treatment if prolonged or significant diarrhoea or abdominal cramps occur (SPC §4.4)

Interactions

SPC §4.5: no interaction studies have been performed

Clinical monograph

How it works

It inhibits bacterial isoleucyl-tRNA synthetase, halting protein synthesis; this distinct mechanism means little cross-resistance with other antibiotic classes.

Prescribing in practice

Limit the duration of use and avoid repeated or prolonged courses to reduce the risk of resistance.
It is intended for small, localised areas, not for large surface areas or widespread infection.
A specific nasal formulation is used for MRSA nasal carriage; the skin ointment and nasal preparation are not interchangeable.

Monitoring

Review clinically for response over the treatment course; if there is no improvement, reconsider the diagnosis, consider swabs for sensitivities and review for resistance.

Counselling the patient

Apply a small amount to the affected area as directed and wash your hands afterwards.
Use it only for the short course prescribed and do not keep using leftover ointment for new problems.
Avoid contact with the eyes; seek advice if the skin becomes more irritated.

Evidence & guidelines

Effective for localised impetigo and central to MRSA decolonisation regimens; UK guidance stresses short, targeted courses to preserve activity.

Reference: NICE NG153 Impetigo; PHE MRSA Decolonisation Guidance; BAD Impetigo Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways