Understanding Contraindications: When Should You Not Use Mupirocin?

October 12, 2025 •

3 min read

Globally, mupirocin is one of the most widely used topical antibiotics for treating skin infections like impetigo. You should not use mupirocin if you have a known allergy to it or on large open wounds if you have kidney problems.

Quick Summary

Key contraindications for mupirocin include known hypersensitivity, use on large open wounds or burns in patients with renal impairment, and application to the eyes or other mucous membranes.

Key Points

Allergy: Do not use if you have a known hypersensitivity to mupirocin or any of its ingredients, including polyethylene glycol.
Kidney Impairment: Avoid using mupirocin ointment on large open wounds or burns, as its polyethylene glycol base can be absorbed and cause kidney damage, especially in those with pre-existing renal issues.
Mucous Membranes: Mupirocin cream and ointment are for skin use only and should not be applied in the eyes, mouth, or inside the nose.
Prolonged Use: Using mupirocin for extended periods can lead to fungal overgrowth and the development of antibiotic-resistant bacteria.
IV Sites: The ointment should not be used at or near central intravenous (IV) sites due to the risk of promoting fungal infections and resistance.
Specific Formulations: Use only the designated nasal ointment for intranasal application; do not use the standard topical ointment in the nose.
No Improvement: If the skin infection does not show improvement within 3 to 5 days of starting treatment, contact a healthcare provider.

Mupirocin, often known by the brand name Bactroban, is a topical antibiotic prescribed to treat bacterial skin infections, such as impetigo and infections caused by Staphylococcus aureus (including MRSA) and Streptococcus pyogenes. While highly effective, there are specific circumstances and conditions where its use is not recommended or requires caution.

Absolute Contraindication: Known Hypersensitivity

The primary reason to avoid mupirocin is a known allergy or hypersensitivity to mupirocin or any of its ingredients, such as polyethylene glycol (PEG) found in the ointment. Allergic reactions can range from localized skin irritation to severe systemic reactions. If an allergic reaction occurs, discontinue use and seek medical help.

Critical Warnings and Precautions

Use on Large Wounds and in Patients with Kidney Disease

Mupirocin ointment contains polyethylene glycol (PEG), which can be absorbed through open wounds and is excreted by the kidneys. In patients with moderate to severe renal impairment, applying the ointment on large, open wounds or extensive burns can lead to toxic levels of PEG, potentially causing or worsening kidney damage. Therefore, mupirocin ointment should not be used in situations with potential for significant PEG absorption, especially with renal impairment.

Application on Mucous Membranes and Eyes

Mupirocin ointment and cream are for external use on the skin only and should not be applied to mucosal surfaces like the eyes, inside the nose, or mouth. Accidental eye contact should be followed by thorough rinsing with water. A specific nasal formulation is available for intranasal use.

Risk of Overgrowth and Antibiotic Resistance

Prolonged antibiotic use, including topical mupirocin, can disrupt the skin's microbial balance, potentially leading to overgrowth of non-susceptible organisms like fungi. Extended use can also contribute to antibiotic resistance. If the infection doesn't improve within 3 to 5 days, a healthcare provider should re-evaluate treatment.


Formulation	Prohibited Areas of Use	Key Considerations
Mupirocin Ointment/Cream	Eyes, inside the nose, mouth, other mucous membranes	Ointment contains PEG; avoid on large open wounds/burns in patients with kidney problems.
Mupirocin Nasal Ointment	Eyes, on the skin (for skin infections)	For nasal MRSA eradication only.

Special Populations

Pregnancy and Breastfeeding: Data is limited, but systemic absorption is minimal. Risk to a nursing infant is considered low, but if applied to the breast/nipple, wash thoroughly before feeding.
Pediatrics: Safety is not established for cream in children under 3 months and ointment under 2 months.
IV Sites: Avoid use on skin near IV cannulae or central IV sites due to increased risk of fungal infections and resistance.

Conclusion

Mupirocin is effective for bacterial skin infections, but its use requires careful consideration of contraindications and warnings. The main reasons to avoid mupirocin are a known allergy, use on large open wounds in individuals with kidney issues, and application to the eyes or mucous membranes. Limiting use to the prescribed duration helps prevent fungal overgrowth and antibiotic resistance. Always consult a healthcare provider to ensure mupirocin is appropriate and safe for your condition.

For more detailed information, consult the official patient information leaflet provided by the U.S. Food and Drug Administration. Link

Frequently Asked Questions

You should not use mupirocin on large open wounds, cuts, or burns, especially if you have kidney problems. The ointment base contains polyethylene glycol (PEG), which can be absorbed through damaged skin and may be harmful to the kidneys.

A penicillin allergy is not a listed contraindication for mupirocin. The primary allergic concern is a known hypersensitivity to mupirocin itself or its components. However, you should always inform your doctor of all your allergies.

Prolonged use of mupirocin can lead to two main problems: the overgrowth of other non-susceptible organisms like fungi, and the development of bacterial resistance, which can make the medication less effective in the future.

No, you should not put mupirocin ointment (for the skin) inside your nose as it can cause irritation. There is a separate prescription product, mupirocin nasal ointment, specifically designed for use inside the nostrils.

If you accidentally get mupirocin in your eyes, you should rinse them well with plenty of cool tap water.

Yes, if you develop a rash, severe itching, or other signs of local irritation or a potential allergic reaction, you should stop using mupirocin and contact your healthcare provider.

There is limited data on mupirocin use in pregnant women, but systemic absorption is minimal. For breastfeeding, the risk to the infant is considered low, but if used on the nipple, the area must be washed thoroughly before nursing.