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Microbiology Mupirocin is an antibacterial agent produced by fermentation using the organism Pseudomonas fluorescens. Mupirocin inhibits bacterial protein synthesis by reversibly and specifically binding to bacterial isoleucyl transfer-RNA synthetase. Due to this mode of action, mupirocin
demonstrates no in vitro cross-resistance with other classes of antimicrobial agents. When mupirocin resistance does occur, it appears to result from the production of a modified isoleucyl-tRNA synthetase. High-level plasmid-mediated resistance (MIC >1024 mcg/mL) has been reported in some strains of S. aureus and coagulase-negative staphylococci. Mupirocin is bactericidal at concentrations achieved topically by intranasal administration. However, the minimum bactericidal concentration (MBC) against relevant intranasal pathogens is generally eight-fold to thirty-fold higher than the minimum inhibitory concentration (MIC). In addition, mupirocin is highly protein bound (>97%), and the effect of nasal secretions on the MIC’s of intranasally applied mupirocin has not been determined. Text Continues Below
Mupirocin has been shown to be active against most strains of methicillin-resistant S. aureus, both in vitro and in clinical studies of the eradication of nasal colonization. Bactroban Nasal only has established clinical utility in nasal eradication as part of a comprehensive program to curtail institutional outbreaks of infections with methicillin-resistant S. aureus. (See INDICATIONS AND USAGE.) The following in vitro data are available, but their clinical significance is unknown. Mupirocin exhibits in vitro MIC’s of 1 mcg/mL or less against most (>90%) strains of methicillin-susceptible S. aureus; however, the safety and effectiveness of mupirocin calcium in eradicating nasal colonization of and preventing subsequent infections due to methicillin-susceptible S. aureus have not been established. Page: << Prev | 1 | 2
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