Topical antibiotic
Updated · Methodology
Adjunct
Infected nipple cracks as entry route for mastitis. Per ABM Protocol #36 2022, thin layer after feeds 2–3 times daily for 5–7 days. Before the next feed – do not wipe off (minimal residue is safe for the infant).
Sources
ICD-10: O91.2 · ICD-11: JB45.1
Natural antibiotic from Pseudomonas fluorescens. Binds bacterial isoleucyl-tRNA synthetase and blocks protein synthesis. Active against Staphylococcus aureus (MSSA and most CA-MRSA), Streptococcus spp. Systemic absorption ≤1% through intact skin, also minimal through broken skin.
Safe in pregnancy.
Fully compatible. Hale L1. Systemic absorption negligible. May leave on nipples before feed – minimal amount in infant's mouth is safe.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
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Mupirocin is evaluated for the following indications with varying evidence strength: Lactational mastitis (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Mupirocin (≥ 1 in 100): Burning at application site, Pruritus, Contact dermatitis. See the Safety section for uncommon and serious reactions.
Safe in pregnancy.
Fully compatible. Hale L1. Systemic absorption negligible. May leave on nipples before feed – minimal amount in infant's mouth is safe.
Mupirocin is contraindicated in: Hypersensitivity to mupirocin; Nasal use in severe immunodeficiency (relative). Full list in the Safety section.
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Calcipotriol, Clotrimazole, Dimetindene, Enoxolone, Iopromide, Isotretinoin, Minoxidil, Sodium bicarbonate