Retapamulin

(USAN, rINN)
Retapamulin Chemical formula
Synonyms: Retapamulina; Rétapamuline; Retapamulinum; SB-275833. (3aS,4R,5S,6S,8R,9R,9aR,10R)-6-Ethenyl-5-hydroxy-4,6,9,10-tetramethyl-1-oxodecahydro-3a,9-propanocyclopenta[8]annulen8-yl{[(1R,3s,5S)-8-methyl-8-azabicyclo[3.2.1]octan-3-yl]sulfanyl}acetate.
Cyrillic synonym: Ретапамулин.

💊 Chemical information

Chemical formula: C30H47NO4S = 517.8.
CAS — 224452-66-8.
ATC — D06AX13.
ATC Vet — QD06AX13.

💊 Adverse Effects and Precautions

Retapamulin is usually well tolerated; the most common reported adverse effect is application site irritation. Other local reactions such as erythema, pain, and pruritus occur rarely. Retapamulin ointment contains butylated hydroxytoluene, which may cause local adverse effects such as contact dermatitis, or irritation to the eyes and mucous membranes. It should not be applied to abscesses. Retapamulin has proved ineffective in infections caused by meticillin-resistant Staphylococcus aureus, and should not be used in their treatment.

💊 Antimicrobial Action

Retapamulin is an antibacterial that selectively inhibits bacterial protein synthesis by binding to the 50S subunit of the ribosome. It is mainly bacteriostatic against meticillin-susceptible Staphylococcus aureus, and streptococci such as Strep. pyogenes. Although in vitro activity has been shown against meticillin-resistant Staph. aureus the in vivo efficacy of retapamulin was found to be inadequate in clinical studies.
1. Pankuch GA, et al. Activity of retapamulin against Streptococcus pyogenes and Staphylococcus aureus evaluated by agar dilution, microdilution, E-test, and disk diffusion methodologies. Antimicrob Agents Chemother 2006; 50: 1727–30
2. Jones RN, et al. Activity of retapamulin (SB-275833), a novel pleuromutilin, against selected resistant Gram-positive cocci. Antimicrob Agents Chemother 2006; 50: 2583–6
3. Rittenhouse S, et al. Selection of retapamulin, a novel pleuromutilin for topical use. Antimicrob Agents Chemother 2006; 50: 3882–5
4. Champney WS, Rodgers WK. Retapamulin inhibition of translation and 50S ribosomal subunit formation in Staphylococcus aureus cells. Antimicrob Agents Chemother 2007; 51: 3385–7.

💊 Pharmacokinetics

Only very small amounts of topically applied retapamulin are absorbed into the systemic circulation. It is about 94% bound to plasma proteins and is shown to be metabolised by mono-oxygenation and N-demeth-
ylation in vitro.

💊 Uses and Administration

Retapamulin is a pleuromutilin antibacterial isolated from the fungus Clitopilus passeckerianus. It is applied topically as a 1% ointment in the treatment of impetigo and other bacterial skin infections due to meticillinsusceptible Staphylococcus aureus and Streptococcus pyogenes. The preparation should be applied twice daily for 5 days; treatment should be re-evaluated if there is no response within about 3 days. It is not suitable for application to mucous membranes. For further details of skin infections and staphylococcal infections and their treatment.
1. Parish LC, et al. Topical retapamulin ointment (1%, wt/wt) twice daily for 5 days versus oral cephalexin twice daily for 10 days in the treatment of secondarily infected dermatitis: results of a randomized controlled trial. J Am Acad Dermatol 2006; 55: 1003–1013
2. Oranje AP, et al. Topical retapamulin ointment, 1%, versus sodium fusidate ointment, 2%, for impetigo: a randomized, observerblinded, noninferiority study. Dermatology 2007; 215: 331–40
3. Yang LPH, Keam SJ. Retapamulin: a review of its use in the management of impetigo and other uncomplicated superficial skin infections. Drugs 2008; 68: 855–73.

💊 Preparations

Proprietary Preparations

Cz.: Altargo; UK: Altargo; USA: Altabax.
Published May 08, 2019.