# Therapeutic Efficacy of 2% Mupirocin in Managing Staphylococcus aureus and Streptococcus pyogenes Wound Infections

## TL;DR

A study found that 2% mupirocin cream is highly effective and safe for treating skin infections caused by Staphylococcus aureus and Streptococcus pyogenes, especially in children.

## Contribution

The study provides real-world evidence supporting the use of 2% mupirocin cream as a first-line treatment for superficial wound infections.

## Key findings

- 99.2% of patients showed a favorable response to 2% mupirocin cream over 10 days.
- Only 0.7% of patients experienced an allergic reaction.
- Mupirocin was effective against both S. aureus and S. pyogenes infections.

## Abstract

Background

Skin and soft tissue infections are a significant healthcare concern, ranging from mild cases treated with topical therapy to severe infections requiring systemic antibiotics and surgical intervention. The increasing global antibiotic resistance, particularly involving Staphylococcus aureus and Streptococcus pyogenes, complicates the management of these infections. Mupirocin, a topical antibiotic, has shown remarkable efficacy in treating infections caused by these pathogens. This quasi-experimental study aimed to evaluate the short-term efficacy and safety of 2% topical mupirocin cream in treating superficial traumatic and surgical wounds infected with S. aureus and/or S. pyogenes among patients, predominantly pediatric, at the Dominican Dermatological Institute and Skin Surgery “Dr. Huberto Bogaert Díaz.” Efficacy was assessed using the Severity of Infected Wounds Scale (SIRS), and safety was determined based on adverse effects over an 11-day follow-up period. The study seeks to inform real-world management strategies and reduce reliance on systemic antibiotics.

Methodology

A quasi-experimental study was conducted between January and April 2023 at the Dominican Dermatological Institute and Skin Surgery “Dr. Huberto Bogaert Díaz.” Patients presenting with clinically infected wounds were enrolled to assess the efficacy of 2% mupirocin cream. The intervention involved applying the cream three times daily for 10 days. The primary outcomes were therapeutic response and incidence of adverse effects. Therapeutic response was assessed using SIRS, which evaluates erythema, swelling, discharge, and local warmth, each scored from 0 (absent) to 3 (severe), for a total score ranging from 0 to 12. Baseline scores were recorded on day one, and follow-up scores on day 11. A therapeutic response was defined as a reduction of 50% or more in the total SIRS score compared to baseline. Adverse effects were monitored through physical examination and patient interviews.

Results

Of the 135 patients treated, 134 (99.2%) exhibited a favorable therapeutic response without adverse effects. Only one (0.7%) patient developed an allergic reaction, characterized by a skin rash, which led to the discontinuation of the treatment. S. aureus was isolated in 76 (56.3%) patients, S. pyogenes in 3 (2.2%) patients, and both pathogens in 56 (41.5%) patients.

Conclusions

The study confirms that 2% mupirocin cream is highly effective and safe for treating superficial wounds infected by S. aureus and/or S. pyogenes. The low incidence of adverse reactions suggests that mupirocin can be considered a first-line topical therapy for such infections, potentially reducing the need for systemic antibiotics and mitigating the risk of systemic antibiotic resistance.