Mupirocin — NZ Medication Guide

What is Mupirocin?

Mupirocin (generic name: mupirocin) is a medication used primarily for bacterial skin infections including impetigo and nasal MRSA decolonisation. Mupirocin 2% ointment (Bactroban) is a prescription-only medicine funded by Pharmac on the Pharmaceutical Schedule in New Zealand.

What is Mupirocin Used For?

Mupirocin is prescribed by healthcare professionals in New Zealand for the following indications:

• Impetigo (school sores) caused by Staphylococcus aureus or Streptococcus pyogenes
• Infected skin wounds and minor cuts
• Secondary bacterial skin infections
• Nasal decolonisation of MRSA before surgery
• Folliculitis and superficial skin infections

How Does Mupirocin Work?

Mupirocin is a topical antibiotic that inhibits bacterial isoleucyl-transfer RNA synthetase, an enzyme essential for protein synthesis. This mechanism is unique among topical antibiotics, meaning there is no cross-resistance with other antibiotic classes. It is active against Staphylococcus aureus (including MRSA) and streptococcal species.

How to Take Mupirocin

For skin infections (2% ointment or cream): apply a small amount to the affected area 3 times daily for 5–10 days. For nasal decolonisation (2% nasal ointment): apply to each nostril twice daily for 5 days. Wash hands before and after application. Do not use in eyes. Do not use on large areas of broken skin or for longer than 10 days unless directed.

Common Side Effects

• Local burning, stinging, or itching at application site
• Mild skin dryness or rash
• Nausea (with extensive nasal use)
• Headache (with nasal formulation)
• Taste disturbance (with nasal formulation)

Serious Side Effects — Seek Medical Attention

• Allergic contact dermatitis — widespread rash, severe skin irritation
• Anaphylaxis (very rare)
• Superinfection with resistant organisms if used long-term
• Mupirocin resistance developing with prolonged courses

Drug Interactions

• Other topical preparations — avoid mixing at the same site
• Chlorhexidine — may be used together for MRSA decolonisation protocols at separate times
• Minimal systemic interactions with standard topical use

New Zealand Prescribing Information

BPAC NZ recommends mupirocin for impetigo in school-aged children. Impetigo is common in NZ communities and is a risk factor for rheumatic fever when caused by Group A Streptococcus. For MRSA nasal decolonisation before elective surgery, mupirocin nasal ointment is used as part of hospital infection control protocols. Resistance to mupirocin in MRSA is an emerging concern; repeated courses should be avoided without specialist direction.

Frequently Asked Questions

How do I treat school sores in my child?

Impetigo (school sores) is treated with topical mupirocin (Bactroban) applied 3 times daily for 5–7 days. Keep sores clean and covered with a dressing if possible. Children should stay home from school until sores are crusted and healing. If the infection is widespread or not improving, oral antibiotics may be needed — see your doctor.

What is MRSA decolonisation and why might I need it?

MRSA is a bacterium that some people carry harmlessly in their nose. Before certain surgical procedures, hospitals test and treat carriers to reduce surgical infection risk. Mupirocin nasal ointment applied twice daily for 5 days, often with chlorhexidine wash, is the standard protocol.

References & Further Information

The following New Zealand and international resources were used to inform this page:

• New Zealand Formulary — Mupirocin
• Pharmac — Funded Medicines Schedule
• BPAC NZ — Impetigo (School Sores)
• Medsafe — Bactroban Consumer Information

Reviewed by a Registered Pharmacist — KiwiMeds New Zealand