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Bacitracin vs Mupirocin (Bactroban) – Which Is The Best Ointment For Wound Healing?

Bacitracin vs Mupirocin (Bactroban) – Which Is The Best Ointment For Wound Healing

A wound is a break or opening in the skin.

Types of wounds include:

  • pressure sores;
  • cuts;
  • burns;
  • puncture wounds;
  • scrapes.

Chronic wounds (injuries which have yet to heal after 6 weeks) affect about 5.7 percent of American adults, according to the U.S. Centers for Disease Control and Prevention.

Wound healing, as a normal biological process in the body, is achieved through 4 precise phases, which include – hemostasis (a process which causes bleeding to stop), inflammation, proliferation (it has 3 distinct stages – filling the wound, contraction of the wound margins, and covering the wound), and remodeling.

Wound healing can be delayed by factors local to the wound itself, including infection or abnormal bacterial presence, desiccation, necrosis, maceration, trauma, pressure, and edema.

Immunosuppressants may weaken the immune system and increase the risk of infection, while anticoagulants have the capacity to disrupt blood clotting.

The following antibiotics can be used for wound healing to prevent infection in minor scrapes, cuts, and burns:

Bacitracin

This antibiotic is produced by a strain of B. subtilis recovered from the débrided tissue removed from a compound fracture.

It is not inhibited by the penicillinase producers and has a wide antibacterial spectrum.

Mupirocin

It is a topical antibiotic useful against superficial skin infections and is found under the brand names of Centany and Bactroban.

It is also called pseudomonic acid thanks to its major metabolite, derived from submerged fermentation of Pseudomonas fluorescens (a common Gram-negative, rod-shaped bacterium).

Uses

Bacitracin is produced by Bacillus subtilis and has a potent bactericidal activity directed mainly against Gram-positive organisms.

It is used to prevent minor skin infections caused by small scrapes and cuts.

Mupirocin is active against the organisms responsible for the majority of skin infections, e.g. Staphylococcus aureus (a Gram-positive, round-shaped bacterium), including methicillin-resistant strains.

Mechanism of Action

Bacitracin works by stopping the growth of bacteria.

Mupirocin is mainly efficacious against Gram-positive aerobes and works by binding to bacterial isoleucyl transfer RNA synthetase.

This inhibits bacterial protein synthesis.

Side Effects

Bacitracin

The most common adverse events associated with this medication treatment during clinical studies included:

  • vomiting;
  • mild skin rash;
  • burning where the drug is applied;
  • nausea.

Call your doctor at once if you have a serious side effect such as:

  • swelling of your face, lips, tongue, or throat;
  • difficult breathing;
  • hives.

Mupirocin

Image credit – https://commons.wikimedia.org/wiki/File:Bactroban.JPG

The most common adverse events associated with this medication treatment during clinical studies included:

  • swelling of the treated skin;
  • tenderness;
  • increased oozing at the infection site;
  • redness and dryness at the infection site;
  • nausea.

Call your doctor at once if you have a serious side effect such as:

  • abnormal heart rhythm;
  • toxicity to organs of hearing;
  • abnormally low blood pressure;
  • a toxic effect on the brain;
  • decreased lung function;
  • slow heartbeat;
  • drowsiness;
  • seizures;
  • head pain;
  • involuntary quivering.

Dosage

Bacitracin

You may apply this antibiotic to the affected area 1 to 3 times a day.

Apply a small amount of the ointment (enough to cover the area you are treating) to the injured skin.

The antibiotic should not be used for more than a week unless instructed otherwise by the healthcare provider.

Avoid contact between this topical antibiotic and your eyes.

Mupirocin

It is usually used 3 times a day for 10 days. Call your healthcare professional if your symptoms do not improve within 3 to 5 days.

A dressing can be applied over the treated area if needed.

Use only a small amount of the antibiotic.

Warnings & Precautions

Before using bacitracin, tell your healthcare provider if you are allergic to it or if you have any other allergies.

Mupirocin can cause a severe allergic reaction.

Signs and symptoms can include:

  • a panic attack or feeling that bad things are going to happen;
  • trouble breathing or swallowing;
  • the skin on your face or body may become pale or flushed;
  • shortness of breath;
  • chest tightness;
  • body rash;
  • itching;
  • swelling of your throat or tongue.

In addition, mupirocin is not suitable for:

  • use at the site of central venous cannulation;
  • ophthalmic use;
  • use in conjunction with cannulae;
  • intranasal use (in neonates or infants).

Drug Interactions

No drug interactions are known or reported while using these topical antibiotics.

Nevertheless, you should tell your healthcare professional about all the medicines you take including vitamins, non-prescription and prescription medicines, and herbal supplements.

Alcohol or Tobacco

Using alcohol or tobacco with certain drugs may cause negative interactions to occur.

Discuss with your healthcare professional the use of any of these topical antibiotics with alcohol, or tobacco.

Is It Safe During Pregnancy or Breastfeeding?

Bacitracin

There are no well-controlled studies in pregnant or lactating women. But, this antibiotic should be used by pregnant or lactating women only if the possible benefit outweighs the possible risks.

Mupirocin

It is not known if this antibiotic passes into breast milk or if it could negatively affect the breastfed infant.

If this topical antibiotic is prescribed to treat an infection in a cracked nipple, this antibiotic should be thoroughly washed off the nipple before giving a feed to the infant.

The safe use of this antibiotic during pregnancy has not been established in well-done studies.

However, the producer advises that this medication should only be used during pregnancy if the potential benefits outweigh any risks to the developing fetus.

Conclusion – Bacitracin vs Mupirocin (Bactroban)

Bacitracin is a topical antibiotic that is used to help prevent minor skin injuries like scrapes, cuts, and burns from becoming infected.

Mupirocin is a topical antibiotic that is used to treat impetigo (a bacterial infection which involves the superficial skin) and other skin infections caused by bacteria.

It works to kill the bacteria which are causing the infection. These include strains of Streptococcus pyogenes and Staphylococcus aureus.

In conclusion, the active ingredients in both products are antibiotics, therefore, they help prevent infection from minor injuries. However, they work in a different way.

For instance, the antibiotic in Bacitracin stops bacterial growth, while the antibiotic in Mupirocin kills the existing bacteria.

According to a 1999 study that was done at the Department of Medicine, Brooklyn, New York, USA, mupirocin may be more effective than bacitracin for the eradication of Staphylococcus aureus.

Sources

https://www.sciencedirect.com/topics/neuroscience/bacitracin
https://www.sciencedirect.com/topics/neuroscience/mupirocin

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