Treatment of Bacterial Skin Infections: Comparing Tonkin With Mupirocin

A double blind randomized controlled trial on the safety and effectiveness of 10% Ipomoea muricata (Tonkin) ointment vs. mupirocin ointment for the treatment of localized primary bacterial skin infections

Melanie Pauline G. Chao-Lo, Arnelfa C. Paliza, Daisy G. Cauilan, Jocelyn D. Domingo, Zennie B. Aceron Department of Dermatology, University of Santo Tomas Hospital, Philippines

Background: Skin pyodermas caused by Group A Streptococcus and Staphylococcus aureus may be treated with topical mupirocin but resistant strains have emerged. The extract of Ipomoea muricata ―Tonkin‖ exhibits antimicrobial activity.

Objectives: The main objective is to determine the safety and effectiveness of 10% Tonkin ointment compared to mupirocin ointment in treating localized pyodermas based on clinical effectiveness using (a) global assessment scores of the signs and symptoms and (b) clearance rate; and bacteriologic efficacy using (a) the zones of inhibition to the test drugs and (b) Gram‘s stain during treatment.

Methodology: Eighty patients, diagnosed with pyoderma, confirmed through Gram‘s stain and/or bacterial culture, applied either 10% Tonkin ointment or mupirocin ointment thrice daily for 14 days. Gram‘s stain was repeated on days 7 and 14. Mean global assessment scores of signs and symptoms and clearance rates were evaluated at days 0,3,7,10,14 and 2 weeks posttreatment. The primary outcome measures were clinical response and bacteriologic cure at day 14.

Results: There were forty patients in each treatment group. On day 14 of treatment, bacteriologic cure was 100% in both groups. Intention to treat analysis showed no significant difference in the mean global assessment scores between the Tonkin–treated (83%) and mupirocin-treated patients (85%) Complete cure was noted in 83% (33/40) of Tonkin-treated and in 85% (34/40) of mupirocin-treated patients. One Tonkin-treated patient had miliaria rubra due to overzealous drug applications which resolved later. No other adverse reactions were seen.

Conclusion: The locally produced 10% Tonkin ointment is equally safe and effective as mupirocin ointment for the treatment of mild to moderate skin pyodermas with minimal local side effects.

Source of Information: Free Paper Presentations. 20th Regional Conference of Dermatology (RCD) – Manila, Phillipines