Pharmacology of Mupirocin in Nasal Application in Healthy Volunteers: Monocentric Study

NCT ID: NCT06368856

Last Updated: 2025-07-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE1

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-29

Study Completion Date

2025-12-31

Brief Summary

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Mupirocin is an old antibiotic used topically since the 1970s. Initially used in the treatment of skin infections for its antistaphylococcal action, it is now part of the decolonization strategy for Staphylococcus aureus (SA) carriage, in association with chlorhexidine. This decolonization strategy has been recommended in France for preoperative cardiac surgery in nasal SA carriers since 2013 by the French Hospital Hygiene Society, and recommended for cardiac and orthopedic surgery in SA carriers by the World Health Organization (WHO) since 2016. This strategy includes nasal decolonization using mupirocin ointment nasally (2 to 3 applications/day), a daily shower with chlorhexidine soap and + /- mouthwashes all over 5 days, often pre-operatively.

As a result, mupirocin is now widely used throughout the world, all the more so as, for reasons of ease of organization, many centers use this decolonization procedure universally (i.e. without prior screening for Staphylococcus aureus carriage), thus further increasing the use of this molecule.

Mupirocin administration methods are very vague, ranging from 2 to 3 applications per day and the application of "a match head", i.e. 50 mg, to 500 mg per nostril.

Mupirocin is bacteriostatic at low doses, becoming bactericidal at higher concentrations; low concentrations could favor the selection of resistance, so using the most effective dosage seems essential. This lack of precision in administration is linked to an almost complete ignorance of the pharmacokinetics of mupirocin and its metabolite (monic acid) after nasal application.

It therefore seems essential to conduct a pharmacokinetic study of this molecule, in order to eventually offer patients the regimen with the administration methods offering the best characteristics in terms of dosage and efficacy.

Detailed Description

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Conditions

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Healthy Staphylococcus Aureus Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Single-center, randomized, open-label pharmacokinetic study of mupirocin in 40 healthy subjects with 2 randomization :

* first randomization - single dose part : 50mg or 500mg of mupirocin
* wash-out: one month
* second randomization - repeated doses part: 50mg mupirocin twice a day or 50 mg 3 times a day 500mg mupirocin twice a day or 500mg mupirocin 3 times a day
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Single dose part : 50mg mupirocin

\- Single dose part = single dose of 50 mg mupirocin in each nostril

Group Type ACTIVE_COMPARATOR

Mupirocin (50 mg)

Intervention Type DRUG

50 mg de mupirocin

blood samples after Single dose part

Intervention Type BIOLOGICAL

3 blood samples will be performed sampling time ater application of mupirocin (single dose part): 00h30, 1h00, 02h00

nasal swab after Single dose part

Intervention Type DIAGNOSTIC_TEST

7 nasal swab for the detection of S. aureus (type Swab) will be performed after application of mupirocin (single dose part): 00h00, 1h00, 02h00, 04h00, 06h00, 08h00, 12h00

Collection of urine after Single dose part

Intervention Type OTHER

Collection of urine during 12 hours after the application of mupirocin (Single dose part)

Single dose part : 500mg mupirocin

Single dose part = single dose of 500 mg mupirocin in each nostril

Group Type EXPERIMENTAL

Mupirocin (500 mg)

Intervention Type DRUG

500 mg de mupirocin

blood samples after Single dose part

Intervention Type BIOLOGICAL

3 blood samples will be performed sampling time ater application of mupirocin (single dose part): 00h30, 1h00, 02h00

nasal swab after Single dose part

Intervention Type DIAGNOSTIC_TEST

7 nasal swab for the detection of S. aureus (type Swab) will be performed after application of mupirocin (single dose part): 00h00, 1h00, 02h00, 04h00, 06h00, 08h00, 12h00

Collection of urine after Single dose part

Intervention Type OTHER

Collection of urine during 12 hours after the application of mupirocin (Single dose part)

Repeated dose part: Group 1 - 50 mg of mupirocin twice a day

50 mg of mupirocin in each nostril twice a day (morning and evening) for 5 days

Group Type EXPERIMENTAL

Mupirocin (50 mg)

Intervention Type DRUG

50 mg de mupirocin

nasal swab during Repeated dose part

Intervention Type DIAGNOSTIC_TEST

5 nasal swab for the detection of S. aureus (type Swab) will be performed during administration of mupirocin (Repeated dose part): 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

Collection of urine during Repeated dose part

Intervention Type OTHER

5 collections of urine during Repeated dose part: 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

nasal swab after Repeated dose part

Intervention Type OTHER

2 nasal swab for the detection of S. aureus (type Swab) will be performed: 1, 3 months after the first application of mupirocin (Repeated dose part)

Repeated dose part: Group 2 50 mg of mupirocin 3 times a day

50 mg of mupirocin in each nostril 3 times a day (morning, noon and evening) for 5 days

Group Type EXPERIMENTAL

Mupirocin (50 mg)

Intervention Type DRUG

50 mg de mupirocin

nasal swab during Repeated dose part

Intervention Type DIAGNOSTIC_TEST

5 nasal swab for the detection of S. aureus (type Swab) will be performed during administration of mupirocin (Repeated dose part): 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

Collection of urine during Repeated dose part

Intervention Type OTHER

5 collections of urine during Repeated dose part: 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

nasal swab after Repeated dose part

Intervention Type OTHER

2 nasal swab for the detection of S. aureus (type Swab) will be performed: 1, 3 months after the first application of mupirocin (Repeated dose part)

Repeated dose part: Group 3 500 mg of mupirocin twice a day

500 mg of mupirocin in each nostril twice a day (morning and evening) for 5 days

Group Type EXPERIMENTAL

Mupirocin (500 mg)

Intervention Type DRUG

500 mg de mupirocin

nasal swab during Repeated dose part

Intervention Type DIAGNOSTIC_TEST

5 nasal swab for the detection of S. aureus (type Swab) will be performed during administration of mupirocin (Repeated dose part): 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

Collection of urine during Repeated dose part

Intervention Type OTHER

5 collections of urine during Repeated dose part: 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

nasal swab after Repeated dose part

Intervention Type OTHER

2 nasal swab for the detection of S. aureus (type Swab) will be performed: 1, 3 months after the first application of mupirocin (Repeated dose part)

Repeated dose part: Group 4 500 mg of mupirocin 3 times a day

500 mg of mupirocin in each nostril 3 times a day (morning non and evening) for 5 days

Group Type EXPERIMENTAL

Mupirocin (500 mg)

Intervention Type DRUG

500 mg de mupirocin

nasal swab during Repeated dose part

Intervention Type DIAGNOSTIC_TEST

5 nasal swab for the detection of S. aureus (type Swab) will be performed during administration of mupirocin (Repeated dose part): 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

Collection of urine during Repeated dose part

Intervention Type OTHER

5 collections of urine during Repeated dose part: 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

nasal swab after Repeated dose part

Intervention Type OTHER

2 nasal swab for the detection of S. aureus (type Swab) will be performed: 1, 3 months after the first application of mupirocin (Repeated dose part)

Interventions

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Mupirocin (50 mg)

50 mg de mupirocin

Intervention Type DRUG

Mupirocin (500 mg)

500 mg de mupirocin

Intervention Type DRUG

blood samples after Single dose part

3 blood samples will be performed sampling time ater application of mupirocin (single dose part): 00h30, 1h00, 02h00

Intervention Type BIOLOGICAL

nasal swab after Single dose part

7 nasal swab for the detection of S. aureus (type Swab) will be performed after application of mupirocin (single dose part): 00h00, 1h00, 02h00, 04h00, 06h00, 08h00, 12h00

Intervention Type DIAGNOSTIC_TEST

Collection of urine after Single dose part

Collection of urine during 12 hours after the application of mupirocin (Single dose part)

Intervention Type OTHER

nasal swab during Repeated dose part

5 nasal swab for the detection of S. aureus (type Swab) will be performed during administration of mupirocin (Repeated dose part): 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

Intervention Type DIAGNOSTIC_TEST

Collection of urine during Repeated dose part

5 collections of urine during Repeated dose part: 2, 3, 4, 5 et 6 days after the first application of mupirocin (Repeated dose part)

Intervention Type OTHER

nasal swab after Repeated dose part

2 nasal swab for the detection of S. aureus (type Swab) will be performed: 1, 3 months after the first application of mupirocin (Repeated dose part)

Intervention Type OTHER

Other Intervention Names

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Bactroban Bactroban intranasal concentrations

Eligibility Criteria

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Inclusion Criteria

* Subject affiliated or entitled to a social security plan
* Subject having signed the consent to participate in the study

Exclusion Criteria

* Pregnancy in progress
* Acute or chronic rhinorrhea
* Allergy to mupirocin calcium or excipients
* Any medication taken during the week preceding the beginning of the study
* Notable medical history (cardiovascular, pulmonary, neurological pathology, etc.)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Centre Hospitalier Universitaire de Saint Etienne

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kasra AZARNOUSH, MD PhD

Role: PRINCIPAL_INVESTIGATOR

CHU SAINT-ETIENNE

Locations

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CHU de SAINT-ETIENNE

Saint-Etienne, , France

Site Status

Countries

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France

Other Identifiers

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2020-006105-30

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

20CH024

Identifier Type: -

Identifier Source: org_study_id

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