mupirocin and Pyoderma

Although topical antibiotics have been considered less than effective agents in the treatment of "impetigo," recent experience suggests that topical therapy has a place as primary treatment of pyoderma and impetigo. This bacteriologically controlled, randomized study compared the safety and efficacy of mupirocin with oral erythromycin in the treatment of pyoderma and impetigo. A total of 29 mupirocin-treated and 30 erythromycin-treated patients completed the study. None of the mupirocin-treated patients reported adverse experiences compared with 4 erythromycin-treated patients who reported 6 adverse experiences. The mupirocin-treated group had a significantly higher benefit:risk ratio than the erythromycin-treated group as measured by the investigator's global evaluation (P = 0.01). Both treatments eradicated 100% of the two most common pathogens, Staphylococcus aureus and Streptococcus pyogenes. Results from this study demonstrate that mupirocin is as effective as systemic erythromycin ethylsuccinate for treatment of pyoderma and impetigo.

Topics: Administration, Topical; Anti-Bacterial Agents; Erythromycin; Evaluation Studies as Topic; Fatty Acids; Humans; Infant; Mupirocin; Pyoderma

Because the effectiveness of topical antimicrobials in the treatment of ecthyma, impetigo, and pyoderma is not well established, the US Food and Drug Administration has recently proposed guidelines for tests of topical antimicrobial efficacy in primary skin infections. The guidelines require both comparison with the agent's base and microbiologic documentation of efficacy. These guidelines were followed in this double-blind, eight-day evaluation of impetigo/ecthyma treated with mupirocin, a new agent that is only active topically. All cultures, before and after therapy, were taken using swabs dipped in neutralizing broth plus 10% fetal bovine serum to minimize antimicrobial "carry over" to the culture plate. Staphylococcus aureus, which was isolated from 94% of the patients before therapy, was eliminated in 88% of the mupirocin-treated patients and 47% of the vehicle-treated patients. Group A beta-hemolytic streptococci were eliminated in 100% of the mupirocin-treated and 0% of the vehicle-treated patients. To our knowledge, this is the first topical antibacterial treatment for primary skin infections proved superior to its vehicle using the proposed US Food and Drug Administration guidelines.

Topics: Administration, Topical; Anti-Bacterial Agents; Child; Child, Preschool; Clinical Trials as Topic; Double-Blind Method; Fatty Acids; Female; Humans; Impetigo; Male; Mupirocin; Pharmaceutical Vehicles; Pyoderma; Random Allocation

Topics: Anti-Bacterial Agents; Child; Child, Preschool; Clinical Trials as Topic; Eczema; Fatty Acids; Female; Humans; Impetigo; Infant; Male; Mupirocin; Pyoderma; Skin Ulcer

Necrobiosis lipoidica (NL) is a granulomatous inflammatory skin disease strongly associated with diabetes mellitus (DM). Red-brown papules expanding into plaques with erythematous indurated borders on the lower extremities are characteristic of NL. Diagnosis is made clinically; however, biopsy of lesions confirms the diagnosis. Untreated NL may ulcerate and lead to further complications, but progression to superimposed pyoderma vegetans (PV) is not a known occurrence.

Topics: Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents; Betamethasone; Cephalexin; Female; Humans; Mupirocin; Necrobiosis Lipoidica; Pyoderma; Skin Diseases, Bacterial

Mupirocin is a topical antibacterial drug used for the treatment of staphylococcal infections, including meticillin-resistant Staphylococcus pseudintermedius (MRSP). The recent emergence of resistance to mupirocin is a major concern in many countries.. This study investigated the prevalence and genotype of mupirocin-resistant S. pseudintermedius isolated from pet dogs with pyoderma.. A total of 110 clinical isolates of S. pseudintermedius were collected from dogs with pyoderma (n = 110) between July 2010 and September 2016. All animals were client-owned dogs.. Low- and high-level mupirocin resistance were evaluated with both the broth microdilution and disk diffusion tests. Mupirocin resistance in S. pseudintermedius isolates was confirmed by genetic analysis of the ileS-2 and naïve ileS genes.. MRSP and meticillin-susceptible S. pseudintermedius were detected in 69 and 41 dogs, respectively. One MRSP strain was highly resistant to mupirocin and contained the high-level mupirocin resistance gene ileS-2. There were no low-level mupirocin-resistant isolates.. Mupirocin is a useful topical antibacterial for MRSP, but a clinical MRSP isolate that had not previously been exposed to mupirocin exhibited the high-level mupirocin resistance in phenotype and genotype. Therefore, continuous monitoring for mupirocin resistance is important in small animal practice.

Topics: Animals; Anti-Bacterial Agents; Dog Diseases; Dogs; Genotype; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Mupirocin; Prevalence; Pyoderma; Republic of Korea; Staphylococcal Skin Infections; Staphylococcus

Resistance to mupirocin was analysed in Staphylococcus spp. isolated from healthy dogs (n=21) and dogs with pyoderma (n=47) or otitis externa (n=52). Isolates were identified to species level by MALDI-TOF and PCR-RFLP of the groEL gene. One isolate of Staphylococcus epidermidis from the skin of a healthy dog, which harboured a plasmid carrying the mupA gene, was resistant to mupirocin.

Topics: Animals; Bacterial Proteins; Chaperonin 60; Dog Diseases; Dogs; Drug Resistance, Bacterial; Mupirocin; Otitis Externa; Pyoderma; Skin; Staphylococcal Infections; Staphylococcus epidermidis

In the United States, veterinary use of mupirocin is primarily limited to the treatment of canine pyoderma caused by methicillin-resistant Staphylococcus pseudintermedius (MRSP). In this study, only 1 of 581 S. pseudintermedius isolates tested was resistant to mupirocin and carried the high-level mupirocin resistance gene, ileS2, on a plasmid.

Topics: Animals; Anti-Bacterial Agents; DNA, Bacterial; Dogs; Drug Resistance, Bacterial; Genes, Bacterial; Molecular Sequence Data; Mupirocin; Polymerase Chain Reaction; Prevalence; Pyoderma; Sequence Analysis, DNA; Staphylococcal Infections; Staphylococcus; United States

The aim of the present post marketing study was to study the safety and efficacy of supirocin-B ointment (mupirocin 2% + betamethasone dipropionate 0.05%) in the treatment of infected dermatoses. For this purpose physicians from different parts of India were requested to keep the clinical records prospectively as per a specially designed proforma over a follow-up period of 7 days, whenever they prescribed supirocin-B ointment (mupirocin 2% + betamethasone dipropionate 0.05%) for local application, three times a day, to their patients having either primary infection complicated by dermatoses or dermatoses infected secondarily. From the analysis of 251 clinical records contributed by 27 physicians, it was evident that in clinical practice, supirocin-B ointment (mupirocin 2% + betamethasone dipropionate 0.05%) was found to be safe and very effective by physicians in the treatment of infected dermatoses in 94.8% of the patients. Similarly 92.4% of the patients reported more than 70% improvement in their symptoms after 7 days of treatment. No adverse effects were reported during the treatment period by any of the patients except worsening of skin lesions by one patient. Thus from this study, supirocin-B ointment (mupirocin 2% + betamethasone dipropionate 0.05%) seems to be safe and effective in the treatment of infected dermatoses.

Topics: Betamethasone; Drug Combinations; Humans; India; Mupirocin; Ointments; Product Surveillance, Postmarketing; Pyoderma; Staphylococcal Skin Infections; Streptococcal Infections; Treatment Outcome

Cutaneous infections with Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas aeruginosa are major complications of epidermolysis bullosa. Application of impermeable occlusive dressings over denuded skin colonized with these bacteria results in rapid multiplication and the hazard of severe pyoderma. Approaches to the prophylactic treatment of these infections during the long-term management of epidermolysis bullosa are considered.

Topics: Administration, Cutaneous; Anti-Bacterial Agents; Epidermolysis Bullosa; Fatty Acids; Humans; Mupirocin; Occlusive Dressings; Pyoderma; Staphylococcal Skin Infections; Streptococcal Infections; Streptococcus pyogenes