mupirocin and Dermatitis

A double-blind, randomized, vehicle-controlled study was conducted to evaluate the safety and efficacy of 2% mupirocin ointment in the treatment of secondarily infected dermatoses. One hundred six patients were enrolled, 92 of whom were evaluable for efficacy. There was a significantly greater rate of eradication of Staphylococcus aureus and total pathogens in mupirocin-treated patients than in control subjects. Analysis of the clinical data relative to all pathogens showed a significant difference in skin infection evaluations performed at the interim and follow-up visits, which favored the mupirocin-treated groups. In those patients infected with S. aureus or Streptococcus pyogenes, there was a significant difference at end-point that favored mupirocin in seven clinical ratings and the skin infection evaluation at follow-up. Mild local adverse effects were noted in a small percentage of patients in each group. Mupirocin appears to be safe and effective for the treatment of secondarily infected dermatoses, especially in those infections caused by Staphylococcus aureus.

Topics: Adolescent; Anti-Bacterial Agents; Bacterial Infections; Dermatitis; Double-Blind Method; Fatty Acids; Humans; Mupirocin; Ointments; Randomized Controlled Trials as Topic; Staphylococcal Skin Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus pyogenes

Topics: Administration, Oral; Administration, Topical; Bacterial Infections; Dermatitis; Erythromycin; Fatty Acids; Humans; Mupirocin; Staphylococcal Infections

Staphylococcus aureus skin infections represent a significant public health threat because of the emergence of antibiotic-resistant strains such as methicillin-resistant S. aureus (MRSA). As greater understanding of protective immune responses and more effective antimicrobial therapies are needed, a S. aureus skin wound infection model was developed in which full-thickness scalpel cuts on the backs of mice were infected with a bioluminescent S. aureus (methicillin sensitive) or USA300 community-acquired MRSA strain and in vivo imaging was used to noninvasively monitor the bacterial burden. In addition, the infection-induced inflammatory response was quantified using in vivo fluorescence imaging of LysEGFP mice. Using this model, we found that both IL-1α and IL-1β contributed to host defense during a wound infection, whereas IL-1β was more critical during an intradermal S. aureus infection. Furthermore, treatment of a USA300 MRSA skin infection with retapamulin ointment resulted in up to 85-fold reduction in bacterial burden and a 53% decrease in infection-induced inflammation. In contrast, mupirocin ointment had minimal clinical activity against this USA300 strain, resulting in only a 2-fold reduction in bacterial burden. Taken together, this S. aureus wound infection model provides a valuable preclinical screening method to investigate cutaneous immune responses and the efficacy of topical antimicrobial therapies.

Topics: Administration, Topical; Animals; Anti-Bacterial Agents; Bridged Bicyclo Compounds, Heterocyclic; Community-Acquired Infections; Dermatitis; Dermoscopy; Disease Models, Animal; Diterpenes; Drug Monitoring; Green Fluorescent Proteins; Interleukin-1alpha; Interleukin-1beta; Male; Methicillin-Resistant Staphylococcus aureus; Mice; Mice, Inbred C57BL; Mice, Transgenic; Microscopy, Fluorescence; Mupirocin; Staphylococcal Skin Infections

Topics: Administration, Topical; Anal Canal; Anti-Bacterial Agents; Dermatitis; Diagnosis, Differential; Humans; Infant; Male; Mupirocin; Penicillin V; Penicillins; Skin Diseases, Bacterial; Streptococcal Infections; Streptococcus pyogenes; Time Factors