retapamulin


retapamulin

(re-ta-pam-yoo-lin) retapamulin,

Altabax

(trade name)

Classification

Therapeutic: anti infectives
Pharmacologic: pleuromutilins
Pregnancy Category: B

Indications

Topical treatment of impetigo caused by methicillin-susceptibleStaphylococcus aureus or Streptococcus pyogenes.

Action

Interferes with bacterial protein synthesis at the level of the 50S ribosome.

Therapeutic effects

Bacteriostatic action against susceptible organisms.

Pharmacokinetics

Absorption: Minimal systemic absorption.Distribution: Unknown.Metabolism and Excretion: Small amounts absorbed are extensively metabolized.Half-life: Unknown.

Time/action profile

ROUTEONSETPEAKDURATION
TopicalUnknownUnknown12 hr

Contraindications/Precautions

Contraindicated in: No contraindications.Use Cautiously in: Obstetric: Use only in pregnancy when maternal benefit outweighs fetal risk; safe use during lactation not established; Pediatric: Safe use in children <9 mos not established.

Adverse Reactions/Side Effects

Dermatologic

  • application site irritation

Interactions

Drug-Drug interaction

Strong CYP3A4 inhibitors, including ketoconazole may ↑ levels; concomitant use not recommended in children <24 mo.

Route/Dosage

Topical (Adults and Children ≥9 mos) Apply thin layer to affected area (up to 100 cm2 in adults or 2% total body area in children) twice daily for 5 days.

Availability

Ointment: 10 mg/g in 5, 10 and 15 g tubes

Nursing implications

Nursing assessment

  • Assess lesions before and daily during therapy.
  • Monitor for application site irritation (redness, itching, burning, swelling, blistering, oozing). Discontinue, wipe off ointment and use alternative therapy if irritation occurs.

Potential Nursing Diagnoses

Risk for infection (Indications)
Risk for impaired skin integrity (Adverse Reactions)

Implementation

  • Topical: Apply a thin layer to affected area twice daily for 5 days. May be covered with sterile bandage or gauze if desired; may protect from access by infants and young children or accidental transfer to eyes or other areas. Wash hands after application if hands are not area of treatment. Avoid oral, intranasal, ophthalmic, or intravaginal use.

Patient/Family Teaching

  • Instruct patient or parent on correct application technique. Advise patient to apply medication exactly as directed for full course of therapy, even though symptoms have improved.
  • Teach patient and family appropriate hygienic measures to prevent spread of impetigo.
  • Instruct parents to notify school nurse for screening and prevention of transmission.
  • Advise patient to notify health care professional if application site irritation occurs or if there is no improvement within 3–4 days.

Evaluation/Desired Outcomes

  • Healing of skin lesions.