Topical antibiotic (mRNA synthetase inhibitor) Pregnancy: Safe for topical use.

Mupirocin 2% (Nasal / Wound)

Brand names: Bactroban

Adult dose

Dose: Nasal decolonisation: apply to inside of each nostril 2–3 times daily for 5–7 days; Wound: apply 3 times daily for up to 10 days

Route: Topical (nasal or wound ointment)

Frequency: 2–3 times daily

Max: Topical application — no systemic dosing

MRSA nasal decolonisation: apply to lower third of both nostrils 2–3 times daily for 5 days. Wound: mupirocin 2% applied to wound TDS (up to 10 days). Skin infections (impetigo, folliculitis): 3 times daily for 5–10 days.

Paediatric dose

Route: Topical

Frequency: Two to three times daily

Max: Small amount per application

Same as adults. Safe from newborns. MRSA decolonisation in neonates: specialist guidance required. Impetigo: 2% cream or ointment TDS for 5–7 days.

Dose adjustments

Renal

No systemic adjustment.

Hepatic

No systemic adjustment.

Clinical pearls

MRSA decolonisation: combine nasal mupirocin + chlorhexidine body wash + octenisan nasal spray (MRSA bundle)
High-level mupirocin resistance increasing — restrict to clear indications
Impetigo: mupirocin 2% cream equal efficacy to oral flucloxacillin for localised disease
Polyethylene glycol base may cause irritation if used on large open wounds — water-miscible base preferred
Do not use in eyes, mucosal surfaces (other than nose)

Contraindications

Hypersensitivity to mupirocin or polyethylene glycol base

Side effects

Local burning and stinging
Nasal irritation
Headache (with nasal use)
Resistance development (especially Staphylococcus — high-level resistance emerged with overuse)

Interactions

No systemic drug interactions

Monitoring

Wound healing
MRSA swab clearance (post-decolonisation)

Reference: BNFc; BNF; NICE NG118 MRSA; PHE MRSA Decolonisation Guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways