Drawbacks

RCT reports usually note few, if any, side-effects with local antibiotics. The two studies comparing mupirocin with placebo reported none.8,9 In studies comparing mupirocin with fusidic acid, the greasy nature of mupirocin was reported as a side-effect in 7-4% of patients versus 1-0%11; minor itching/ burning occurred in 6/116 (5%) versus 2/50 (4%) respectively.13 No side-effects were reported in Gilbert's study.12 Studies comparing erythromycin versus mupirocin recorded gastrointestinal side-effects in 23% versus 8%,4 none in either group,18 and equal distribution between the two groups.17 Hydrocortisone/potassium hydroxyquinoline caused two cases of mild staining in 65 patients.14 Miconazole caused "mild burning" in one case.15 In general, resistance rates against topical antibiotics such as fusidic acid and mupirocin will rise when an antibiotic is used excessively.

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