Topical
retapamulin (
Altabax,
Altargo) is the first
pleuromutilin antibacterial approved for the treatment of uncomplicated superficial skin
infections caused by Staphylococcus aureus (excluding methicillin-resistant S. aureus [MRSA]) and Streptococcus pyogenes in patients aged > or = 9 months. In the EU,
retapamulin is indicated for use in patients with
impetigo or with infected small
lacerations, abrasions, or sutured
wounds (without
abscesses); in the US, it is indicated for use in patients with
impetigo.
Retapamulin has a novel site of action on bacterial ribosomes. In clinical trials in patients with
impetigo, topical
retapamulin 1%
ointment twice daily for 5 days (the approved regimen) was superior to placebo; treatment with
retapamulin was noninferior to that with topical
fusidic acid. In patients with secondarily infected traumatic lesions, treatment with
retapamulin was noninferior to that with oral
cephalexin, although the efficacy of
retapamulin was reduced in patients with MRSA
infections or superficial
abscesses.
Retapamulin was well tolerated in both pediatric and adult patients, and the majority of adverse events were of mild to moderate severity. Thus, the introduction of topical
retapamulin 1%
ointment extends the treatment options available in the management of
impetigo and uncomplicated secondarily infected traumatic lesions.