Urinary biomarker of mupirocin medication
Research type
Research Study
Full title
Urinary Biomarkers of Mupirocin Medication
IRAS ID
196480
Contact name
Peter G. Mantle
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Development of resistance of disease-causing bacteria to conventional antibiotics is a topical problem of global significance. An important example is MRSA occurring on the body and/or nasal passages and requires decontamination before surgery. A key antibiotic for decontaminating the nose is mupirocin, for which a 5-day regimen of intranasal medication is standard practice. As yet, resistance to mupirocin amongst MRSA in the community is low, but it is important to minimise inadvertent selection of spontaneous variation in bacterial pathogens expressed as mupirocin resistance.
One mechanism for encouraging resistance is non- or partial-compliance among some out-patients with the strict daily regimen of intra-nasal medication, a common problem for use of pharmaceuticals. However, for mupirocin, there is yet no analytical methodology to detect retrospective non-compliance with the mupirocin regimen.
Topically-applied mupirocin cream is poorly absorbed and in any case is degraded rapidly in the digestive tract. This explains why it is only for superficial use. Obviously, mupirocin can only be fully effective against MRSA in the upper nasal region if the small excess of properly applied cream is swallowed harmlessly. We propose to focus on this small ingested fraction and to seek traces of the degraded fragment known as monic acid A that will eventually be excreted in urine. By modern sophisticated spectrometric analysis we have already shown that traces of monic acid A added to human urine can be isolated, characterised and quantified (Haidar et al. 2011).It is proposed to extend this study to demonstrate the monic acid A biomarker in a clinical setting using urine samples from patients taken during their prescribed medication with mupirocin.REC name
East of Scotland Research Ethics Service REC 2
REC reference
16/ES/0031
Date of REC Opinion
19 Feb 2016
REC opinion
Favourable Opinion