Drugs List

Therapeutic Indications

Uses

Eradication of nasal carriage of Staph.including methicill.resist.S.aureus

Contraindications

None known

Precautions and Warnings

Breastfeeding
Pregnancy

Avoid contact with eyes
Prolonged use may result in superinfection with non-susceptible organisms
Discontinue if severe hypersensitivity reactions occur

Pregnancy and Lactation

Pregnancy

Use mupirocin ointment with caution in pregnancy.

The manufacturer notes that this medication should only be considered if the expected benefit to the mother is greater than any risk to the foetus.

There is little data on the use of mupirocin ointment during human pregnancy. Animal studies have not identified any risk to pregnancy or embryo-foetal development.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use mupirocin ointment with caution in breastfeeding.

The manufacturer notes that this medication should only be considered if the expected benefit to the mother is greater than any risk to the breastfed infant.

There is little data on the use of this medication during human lactation. Minimal plasma concentrations and rapid metabolism and elimination, suggests that clinically significant amounts of the antibiotic will not reach the milk.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Allergic reaction
Anaphylaxis
Angioedema
Hypersensitivity reactions
Nasal mucosa reactions
Rash
Urticaria

Presentation

Nasal ointment containing mupirocin calcium.

Drugs List

Therapeutic Indications

Uses

Eradication of nasal carriage of Staph.including methicill.resist.S.aureus

Dosage

A cotton bud may be used for the application to infants or to patients who are very ill.

After application, press the nostrils together as this will spread the ointment throughout the areas.

Adults

Children

Additional Dosage Information

Contraindications

None known

Precautions and Warnings

Breastfeeding
Pregnancy

Avoid contact with eyes
Prolonged use may result in superinfection with non-susceptible organisms
Discontinue if severe hypersensitivity reactions occur

Pregnancy and Lactation

Pregnancy

Use mupirocin ointment with caution in pregnancy.

The manufacturer notes that this medication should only be considered if the expected benefit to the mother is greater than any risk to the foetus.

There is little data on the use of mupirocin ointment during human pregnancy. Animal studies have not identified any risk to pregnancy or embryo-foetal development.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use mupirocin ointment with caution in breastfeeding.

The manufacturer notes that this medication should only be considered if the expected benefit to the mother is greater than any risk to the breastfed infant.

There is little data on the use of this medication during human lactation. Minimal plasma concentrations and rapid metabolism and elimination, suggests that clinically significant amounts of the antibiotic will not reach the milk.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Allergic reaction
Anaphylaxis
Angioedema
Hypersensitivity reactions
Nasal mucosa reactions
Rash
Urticaria

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: October 2018

Reference Sources

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

Summary of Product Characteristics: Bactroban Nasal Ointment 2%. GlaxoSmithKline UK. Revised September 2016.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 03 October 2018