Bactericidal efficacy of mupirocin in multi-antibiotic resistant Staphylococcus aureus born wound infection

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Abstract
Methicillin resistant Staphylococcus aureus strains (MRSA) have become increasingly prevalent as pathogenic organisms, especially in burn wounds, with an associated mortality of 20–40% among those clinically infected. Mupirocin ointment, a new topical antibiotic, has proved in vitro and in vivo to be highly effective in the treatment of MRSA infections. A modified Walker burn wound model was used to define the rate of trans-eschar penetration, biodynamic availability and bactericidal efficacy of 2% mupirocin ointment in established MRSA burn wound infection. In-vitro penetration trials confirmed the effective diffusion of mupirocin through 1·5 mm eschar within 2h. A single topical application of mupirocin resulted in a 98·3% (5·67 × 108 cfu/g of tissue- 1·0 × 107 cfu/g of tissue) reduction in intra-eschar viable organisms within 36 h post application. A second topical application of mupirocin at 24 h resulted in a total reduction of 99·6% in viable intra-eschar organisms (1·85 × 108 cfu/gram of tissue- 6·76 × 105 cfu/g of tissue). It is concluded that mupirocin is highly effective in controlling MRSA burn wound infection and should be applied topically every 24 h.

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