Mupirocin is used as a topical treatment for bacterial skin infections, for example, furuncle, impetigo, open wounds, etc. It is also useful in the treatment of methicillin-resistant Staphylococcus aureus (MRSA), which is a significant cause of death in hospitalized patients having received systemic antibiotic therapy. It is suggested, however, that mupirocin cannot be used for extended periods of time, or indiscriminately, as resistance does develop, and could, if it becomes widespread, destroy mupirocin's value as a treatment for MRSA. It may also result in overgrowth of non-susceptible organisms.Mupirocin reversibly binds to the isoleucyl t-RNA synthetase in Staphylococcus aureus and Streptococcus, resulting in inhibition of protein synthesis. DNA and cell wall formation are also negatively impacted to a lesser degree.The inhibition of RNA synthesis was shown to be a protective mechanism in response to a lack of one amino acid, isoleucine. In vivo studies in Escherichia coli demonstrated that pseudomonic acid inhibits isoleucine t-RNA synthetase (IleRS). This mechanism of action is shared with
furanomycin, an analog of isoleucine.