Abstract
Skin and soft tissue infections (SSTIs) have increased problematically in hospital and ambulatory settings due to the poor immunity of hosts and multidrug-resistant pathogens. Mupirocin (MUP), a global topical antibiotic, is used for the treatment of SSTIs caused by various pathogens due to its unique mechanism of action. However, the therapeutic efficiency of MUP is hampered due to the protein binding and drug resistance caused by frequent use. A combined report covering the various aspects of MUP, such as the synthesis of the novel formulation, loading of the drug, and application against various skin infections, is missing. This comprehensive review focuses on various novel drug delivery strategies such as composite biomaterials/scaffold, hydrogel dressings, liposomes, liposomal hydrogel, microparticles/microspheres, microsponges, nanocapsules, nanofibers, silicone-based adhesive patches, and topical sprays. The therapeutic effect of the MUP can be synergized by combining with other agents and using novel strategies. The objective is to enhance patient compliance, decrease the resistance, magnify the delivery of MUP, and overcome the limitations of conventional formulations. Moreover, the carriers/dressing materials are biocompatible, biodegradable, stimulate wound healing, protect the wound from external environmental contamination, adsorb the wound exudates, and are permeable to oxygen and moisture. This review will help researchers to explore further the treatment of various bacterial skin infections by using MUP-loaded novel formulations with better efficacy, utilizing the novel nanostructures or combinatorial methods.
Highlights
The skin is the largest organ of the human body, which is daily invaded by various environmental factors such as dryness, cold bites, bacteria, fungi, and accidental fires as well
The results revealed that the metabolic degradation of MUP was hampered by the protective lipid layer of NLCS, resulting in a 40-fold and 55-fold area under the curve and half-life, respectively, in contrast to native MUP [64]
Mupirocin is a globally used topical antibiotic for the treatment of various bacterial skin infections owing to its unique mechanism of action; the therapeutic efficacy is hampered due to resistance, poor half-life, and protein binding
Summary
The skin is the largest organ of the human body, which is daily invaded by various environmental factors such as dryness, cold bites, bacteria, fungi, and accidental fires as well. The IDSA classified SSTIs based on “(i) skin extension, complicated infection (deep structures of the skin) and uncomplicated (superficial infections); (ii) rate of progression, acute and chronic wound infections; (iii) tissue necrosis, necrotizing and not necrotizing infections” [11]. The surrounding tissues of the burn wound exhibit warmth, tenderness, induration, and erythema It usually arises 4 days after surgery and is categorized into superficial incisional, deep incisional, and organ or space infection. MUP is one of the widely used topical antibiotics that is effectively used to treat superficial skin infections caused by Gram-positive and Gram-negative bacteria, especially nasal MRSA due to its broad antibacterial spectrum [23,24,25] and antibiofilm property [18,26]. MUP (C26H44O9) is one of the first drugs which was synthesized by the modular polyketide synthases isolated from soil bacteria
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