Mupirocin ointments: In vitro x In vivo bioequivalence evaluation

Abstract Bioequivalence (BE) assessment of topical drug products is a long-standing challenge. Agencies such as the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have published several drafts in recent years suggesting different approaches as alternative to evaluate the BE. A proposed Topical Classification System (TCS) has even been discussed. Given the above, the objective of this research was to use in vitro and in vivo BE approaches to evaluate Brazilian marketed mupirocin (MPC) ointments, previously classified as TCS class The in vitro permeation test (IVPT) was performed by applying formulations to pig skin by Franz cells. The in vivo methodology was dermatopharmacokinetic (DPK). These approaches (in vivo tape stripping and IVPT) demonstrated capability of distinguishing among different formulations, thus making them useful methodologies for BE evaluation.

Development and validation of a liquid chromatographic method for in vitro mupirocin quantification in both skin layers and percutaneous penetration studies.

A simple, rapid, and sensitive reversed-phase high-performance liquid chromatographic (HPLC) method for the measurement of mupirocin concentrations in both skin layers and percutaneous samples has been developed. Mupirocin was extracted from skin layers using PBS-acetonitrile (90:10, v/v). The method is sufficiently sensitive and repeatable to be used in percutaneous penetration studies. The samples were chromatographed on a 250 mm x 4 mm C(8) LiChrospher Select B (5 microm). The mobile phase composition was a mixture of acetonitrile-ammonium acetate 0.05 M (27.5:72.5, v/v) adjusted to pH 6.3 with acetic acid. The analyte was detected at 228 nm and the run time was 11 min. Linearity was confirmed in the concentration range 0.2-20 microg/ml and the limit of detection was 9.5 ng/ml.

Low concentrations of mupirocin in the pharynx following intranasal application may contribute to mupirocin resistance in methicillin-resistant Staphylococcus aureus.

We describe a patient with methicillin-resistant Staphylococcus aureus (MRSA) colonizing the pharynx. The MIC of mupirocin was 0.25 microg/ml before treatment and increased after treatment to 8 microg/ml. Using pulsed-field gel electrophoresis, we confirmed that the genotypes of MRSA that colonized the pharynx before and after the use of mupirocin were identical. We measured the delivery of mupirocin to the pharynx in three normal volunteers and two patients. Low concentrations of mupirocin were present in the pharynx in all cases 10 min to 3 days after intranasal application. Our data suggested that low concentrations of the drug in the pharynx after intranasal application of mupirocin ointment might explain the selection of mupirocin resistance in MRSA.