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Mupirocin is an antibacterial used topically as an ointment or cream on the skin to treat impetigo and skin infections caused by Staphylococcus aureus and Streptococcus pyogenes.
At the time of the last update, we found no published data on its excretion in breast milk.
The small dose and no or negligible plasma absorption through the skin (AEMPS 2007, Pappa 1990), added to its high binding to plasma proteins and moderately high molecular weight, make the passage of significant amounts into breast milk unlikely.
One infant whose mother was treated for mastitis with mupirocin at the breast twice daily (in addition to intravenous teicoplanin and ceftriaxone) did not present any problems.(Kaplan 2017)
Although it has good absorption via the intestinal route, it is rapidly and completely metabolized to monic acid, an inactive metabolite (AEMPS 2007). Even so, it is advisable to remove with a gauze before breastfeeding if it has been applied on the nipple.
It is not more effective than pure lanolin in the control of nipple cracks or sore nipples (Dennis 2012). It is less effective than oral antibiotherapy in treating golden staphylococcal teat infection (Livingstone 1999) and is not effective in preventing mastitis. (Crepinsek 2020)
Creams, gels and other locally applied products containing kerosene (mineral oil) should be avoided on the nipple so that the infant does not absorb it. (Concin 2008, Noti 2003)