Topical Bactroban (mupirocin): Efficacy in treating burn wounds infected with methicillin-resistant staphylococci

L. L. Strock, M. M. Lee, R. L. Rutan, M. H. Desai, M. C. Robson, David Herndon, J. P. Heggers

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Bacterial antimicrobial susceptibility predictors such as the minimal inhibitory concentration (MIC) assay and Nathans Agar Well Diffusion (NAWD) assay provide essential information relevant to the therapeutic approach in burn-wound sepsis. The susceptibilities of 68 gram-positive burn-wound isolates were tested against topical Bactroban (mupirocin) (Beecham Laboratories, Bristol, Tenn.) and compared with other topical antimicrobials such as mafenide acetate, silver sulfadiazine, and bacitracin/neomycin/polymyxin (BNP). Topical susceptibility data were obtained with a modification of NAWD assay. Bactroban's antimicrobial activity was greater than that of mafenide acetate (100% vs 97%), and significantly greater than that of silver sulfadiazine and that of BNP (p < 0.001). Of the 68 isolates that were susceptible to Bactroban, 51 were predominantly methicillin-resistant staphylococci (MRSA). Bactroban showed in vitro activity against 71% of the 85 gram-negative isolates tested. Mafenide acetate showed activity against 89% of these isolates, a significant difference compared with Bactroban (p < 0.02). In general, no significant difference was found between the activities of Bactroban and silver sulfadiazine against the gram-negative isolates. The activities of mafenide acetate and silver sulfadiazine against isolates of Pseudomonas aeruginosa were significantly greater than that of Bactroban (p < 0.05). Bactroban may be used in the treatment of documented staphylococcal burn-wound infections. On the basis of the in vitro data, 13 patients with MRSA burn-wound infections susceptible to Bactroban were evaluated. Quantitative wound biopsies were employed to determine the efficacy of this therapeutic approach. The outcome of these infections was correctly predicted by the NAWD assay in 92.3% of the patients treated (p < 0.0005). The period of treatment ranged from 2 to 17 days. On the basis of these data MRSA burn-wound infections can be successfully treated with Bactroban as determined by the NAWD susceptibility assay.

Original languageEnglish (US)
Pages (from-to)454-459
Number of pages6
JournalJournal of Burn Care and Rehabilitation
Volume11
Issue number5
StatePublished - 1990

Fingerprint

Mupirocin
Methicillin Resistance
Staphylococcus
Mafenide
Wounds and Injuries
Silver Sulfadiazine
Burns
Agar
Wound Infection
Polymyxins
Bacitracin
Neomycin
Therapeutics
Pseudomonas aeruginosa
Sepsis

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery
  • Nursing(all)
  • Health Professions(all)

Cite this

Strock, L. L., Lee, M. M., Rutan, R. L., Desai, M. H., Robson, M. C., Herndon, D., & Heggers, J. P. (1990). Topical Bactroban (mupirocin): Efficacy in treating burn wounds infected with methicillin-resistant staphylococci. Journal of Burn Care and Rehabilitation, 11(5), 454-459.

Topical Bactroban (mupirocin) : Efficacy in treating burn wounds infected with methicillin-resistant staphylococci. / Strock, L. L.; Lee, M. M.; Rutan, R. L.; Desai, M. H.; Robson, M. C.; Herndon, David; Heggers, J. P.

In: Journal of Burn Care and Rehabilitation, Vol. 11, No. 5, 1990, p. 454-459.

Research output: Contribution to journalArticle

Strock, LL, Lee, MM, Rutan, RL, Desai, MH, Robson, MC, Herndon, D & Heggers, JP 1990, 'Topical Bactroban (mupirocin): Efficacy in treating burn wounds infected with methicillin-resistant staphylococci', Journal of Burn Care and Rehabilitation, vol. 11, no. 5, pp. 454-459.
Strock, L. L. ; Lee, M. M. ; Rutan, R. L. ; Desai, M. H. ; Robson, M. C. ; Herndon, David ; Heggers, J. P. / Topical Bactroban (mupirocin) : Efficacy in treating burn wounds infected with methicillin-resistant staphylococci. In: Journal of Burn Care and Rehabilitation. 1990 ; Vol. 11, No. 5. pp. 454-459.
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abstract = "Bacterial antimicrobial susceptibility predictors such as the minimal inhibitory concentration (MIC) assay and Nathans Agar Well Diffusion (NAWD) assay provide essential information relevant to the therapeutic approach in burn-wound sepsis. The susceptibilities of 68 gram-positive burn-wound isolates were tested against topical Bactroban (mupirocin) (Beecham Laboratories, Bristol, Tenn.) and compared with other topical antimicrobials such as mafenide acetate, silver sulfadiazine, and bacitracin/neomycin/polymyxin (BNP). Topical susceptibility data were obtained with a modification of NAWD assay. Bactroban's antimicrobial activity was greater than that of mafenide acetate (100{\%} vs 97{\%}), and significantly greater than that of silver sulfadiazine and that of BNP (p < 0.001). Of the 68 isolates that were susceptible to Bactroban, 51 were predominantly methicillin-resistant staphylococci (MRSA). Bactroban showed in vitro activity against 71{\%} of the 85 gram-negative isolates tested. Mafenide acetate showed activity against 89{\%} of these isolates, a significant difference compared with Bactroban (p < 0.02). In general, no significant difference was found between the activities of Bactroban and silver sulfadiazine against the gram-negative isolates. The activities of mafenide acetate and silver sulfadiazine against isolates of Pseudomonas aeruginosa were significantly greater than that of Bactroban (p < 0.05). Bactroban may be used in the treatment of documented staphylococcal burn-wound infections. On the basis of the in vitro data, 13 patients with MRSA burn-wound infections susceptible to Bactroban were evaluated. Quantitative wound biopsies were employed to determine the efficacy of this therapeutic approach. The outcome of these infections was correctly predicted by the NAWD assay in 92.3{\%} of the patients treated (p < 0.0005). The period of treatment ranged from 2 to 17 days. On the basis of these data MRSA burn-wound infections can be successfully treated with Bactroban as determined by the NAWD susceptibility assay.",
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N2 - Bacterial antimicrobial susceptibility predictors such as the minimal inhibitory concentration (MIC) assay and Nathans Agar Well Diffusion (NAWD) assay provide essential information relevant to the therapeutic approach in burn-wound sepsis. The susceptibilities of 68 gram-positive burn-wound isolates were tested against topical Bactroban (mupirocin) (Beecham Laboratories, Bristol, Tenn.) and compared with other topical antimicrobials such as mafenide acetate, silver sulfadiazine, and bacitracin/neomycin/polymyxin (BNP). Topical susceptibility data were obtained with a modification of NAWD assay. Bactroban's antimicrobial activity was greater than that of mafenide acetate (100% vs 97%), and significantly greater than that of silver sulfadiazine and that of BNP (p < 0.001). Of the 68 isolates that were susceptible to Bactroban, 51 were predominantly methicillin-resistant staphylococci (MRSA). Bactroban showed in vitro activity against 71% of the 85 gram-negative isolates tested. Mafenide acetate showed activity against 89% of these isolates, a significant difference compared with Bactroban (p < 0.02). In general, no significant difference was found between the activities of Bactroban and silver sulfadiazine against the gram-negative isolates. The activities of mafenide acetate and silver sulfadiazine against isolates of Pseudomonas aeruginosa were significantly greater than that of Bactroban (p < 0.05). Bactroban may be used in the treatment of documented staphylococcal burn-wound infections. On the basis of the in vitro data, 13 patients with MRSA burn-wound infections susceptible to Bactroban were evaluated. Quantitative wound biopsies were employed to determine the efficacy of this therapeutic approach. The outcome of these infections was correctly predicted by the NAWD assay in 92.3% of the patients treated (p < 0.0005). The period of treatment ranged from 2 to 17 days. On the basis of these data MRSA burn-wound infections can be successfully treated with Bactroban as determined by the NAWD susceptibility assay.

AB - Bacterial antimicrobial susceptibility predictors such as the minimal inhibitory concentration (MIC) assay and Nathans Agar Well Diffusion (NAWD) assay provide essential information relevant to the therapeutic approach in burn-wound sepsis. The susceptibilities of 68 gram-positive burn-wound isolates were tested against topical Bactroban (mupirocin) (Beecham Laboratories, Bristol, Tenn.) and compared with other topical antimicrobials such as mafenide acetate, silver sulfadiazine, and bacitracin/neomycin/polymyxin (BNP). Topical susceptibility data were obtained with a modification of NAWD assay. Bactroban's antimicrobial activity was greater than that of mafenide acetate (100% vs 97%), and significantly greater than that of silver sulfadiazine and that of BNP (p < 0.001). Of the 68 isolates that were susceptible to Bactroban, 51 were predominantly methicillin-resistant staphylococci (MRSA). Bactroban showed in vitro activity against 71% of the 85 gram-negative isolates tested. Mafenide acetate showed activity against 89% of these isolates, a significant difference compared with Bactroban (p < 0.02). In general, no significant difference was found between the activities of Bactroban and silver sulfadiazine against the gram-negative isolates. The activities of mafenide acetate and silver sulfadiazine against isolates of Pseudomonas aeruginosa were significantly greater than that of Bactroban (p < 0.05). Bactroban may be used in the treatment of documented staphylococcal burn-wound infections. On the basis of the in vitro data, 13 patients with MRSA burn-wound infections susceptible to Bactroban were evaluated. Quantitative wound biopsies were employed to determine the efficacy of this therapeutic approach. The outcome of these infections was correctly predicted by the NAWD assay in 92.3% of the patients treated (p < 0.0005). The period of treatment ranged from 2 to 17 days. On the basis of these data MRSA burn-wound infections can be successfully treated with Bactroban as determined by the NAWD susceptibility assay.

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