Retapamulin: Indications And Efficacy

Retapamulin is a relatively new drug that belongs to the family of antibiotics. As we will see later, it is used topically for the treatment of impetigo and secondary infections in small wounds or in decorations.

Although it is active against infections caused by the bacteria S. aureus and S. pyogenes , retapamulin is not indicated in the treatment of abscesses or in skin infections caused by these two methicillin-resistant bacteria, or in infections secondary to skin disease.

Although we will see it in more detail throughout the article, in clinical trials that have been carried out, treatment with this antibiotic has not been shown to be more effective than fusidic acid in patients with impetigo.

Furthermore, in patients with infections secondary to traumatic injuries, retapamulin has not been shown to be more effective compared to oral cephalexin.

Thus, compared to the drugs of choice for these indications, that is, mupirocin, fusidic acid and oral cephalexin, treatment with retapamulin does not provide additional advantages in terms of efficacy or safety. The cost of this drug is even higher.

Indications of retapamulin

Healing a wound with a bandage

As we have mentioned, this antibiotic is indicated for S. aureus and S. pyogenes infections . Specifically, it is used topically in superficial skin lesions in adolescents, children and infants from nine months of age.

Infections for which it is indicated with the following:

  • Impetigo: Impetigo is a very contagious common skin infection that mainly affects babies and young children. It usually appears as red sores on the face, especially around the nose and mouth, as well as on the hands and feet.
  • Small infected wounds, decorations or saturated wounds.

What are the dosages, administration guidelines, and mechanism of action?

When administering this ointment, a thin layer should be applied to the affected area. This process should be done twice a day for five days. In addition, it is usually recommended to cover the wound or injury with a bandage or sterile gauze, in order to promote the action of the antibiotic.

It is important to note that this antibiotic is only indicated for cutaneous use. If administered by another route, health problems would occur.

On the other hand, in terms of the mechanism of action, retapamulin, indicated for the short-term treatment of impetigo and small infected, saturated and excorated wounds, owes its effect to its ability to inhibit bacterial protein synthesis in the ribosome. It has not shown specific cross-resistance with other classes of antibacterial agents.

How effective has it been?

Scientists working in the laboratory

The efficacy of drugs is obtained through clinical trials. In this case, two trials have been carried out comparing the efficacy of retapamulin against fusidic acid, cephalexin and placebo.

The objective to be studied was the clinical cure rate of the infection. Professionals consider that clinical cure is the resolution or improvement of the infection without requiring the application of another additional antibiotic.

In another trial involving 517 impetigo patients, a clinical cure rate for retapamulin 1% was shown similar to that for fusidic acid 2% ointment.

Adverse reactions

The use of this medicine is not associated with many adverse effects. The most common is irritation in the area where the ointment is applied. Furthermore, the frequency, types and severity of adverse reactions in the pediatric population are the same as in the adult population.

As we have said, the main adverse reaction is irritation. However, others such as itching and erythema can also develop in the treated area. Some cases of hypersensitivity reactions and angioedema have also been reported.


Retapamulin is a semisynthetic antibiotic indicated for the treatment of impetigo  and secondary infections in small wounds or in patches.

Despite being a safe drug and administered topically, it is not without adverse reactions. Therefore, you should always follow the doctor’s instructions and not abuse its use or self-medicate.

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