Comparative Study of Efficacy of Mupirocin and Retapamulin in Impetigo
Abstract Background: Bacterial skin infections are common dermatological conditions, frequently caused by Staphylococcus aureus and group A β-hemolytic Streptococcus pyogenes. The most frequent presentations is impetigo. Impetigo is a contagious bacterial skin infection that affects both adults and children. Topical antibiotics are widely recommended due to their localized efficacy and tolerability. Among these, mupirocin is well established, while retapamulin represents a newer pleuromutilin antibiotic with low resistance potential. Objective: To compare the efficacy and safety of retapamulin and mupirocin ointment in the treatment of Impetigo. Methods: This analytic study included 100 patients with bacterial skin impetigo attending the outpatient and inpatient departments of Dhaka Medical College Hospital. Patients were randomized into two equal groups: 50 patients received retapamulin ointment and rest received mupirocin ointment twice daily for 14 days. Clinical assessments were conducted at baseline and day 7. Patients with prior adverse drug reactions, pregnancy, lactation, or hepatic/renal dysfunctions were excluded. Clinical outcomes were measured using Investigator’s Global Assesement (IGA) scale. Results: The mean age was 31.7 ± 10.4 years, most (44%) were aged 18–28 years, and females constituted 60% of the study population. At baseline, severe erythema was more frequent in the mupirocin group (64% vs. 44%), while retapamulin patients showed less crusting and more moderate tissue warmth. Clinical efficacy analysis revealed that retapamulin produced faster improvement, with significantly higher rates of clinical success at day 7 (48% vs. 22%), day 10 (84% vs. 46%), and day 14 (84% vs. 62%), though by day 21 outcomes were nearly equal (96% vs. 90%). Both drugs were well tolerated, with mild irritation (20% retapamulin, 14% mupirocin), pruritus (2% vs. 8%), and one case of allergic contact dermatitis in the mupirocin group, none of which were statistically significant. Conclusion: Mupirocin and retapamulin were found to be safe and nearly equally effective in treating impetigo, with retapamulin showing slightly earlier clinical improvement. Keywords: Impetigo; Mupirocin; Retapamulin; Topical antibiotics. |