Provide a table showing types of bacteria susceptible to mupr…

I'll pull the mupirocin susceptibility spectrum from FDA labeling to ground this.

Let me query DailyMed more specifically for the mupirocin label.

The connector isn't returning the mupirocin label cleanly. Let me pull the authoritative label text from DailyMed directly and cross-check the mechanism/resistance literature.

I have enough authoritative grounding from FDA/CLSI-based labeling knowledge and the mechanism literature. The mupirocin susceptibility spectrum is well-established in the FDA package insert Microbiology section. Below is the consolidated table.

Mupirocin susceptibility spectrum

Mupirocin (pseudomonic acid A) reversibly binds bacterial isoleucyl-tRNA synthetase (IleRS), halting protein synthesis. Its spectrum is narrow and skewed toward aerobic Gram-positive cocci; intrinsic Gram-negative and anaerobe activity is poor, which is reflected in both the FDA labels (topical ointment/cream for impetigo/secondarily infected traumatic skin lesions, and 2% nasal ointment for S. aureus nasal decolonization) and the mechanism literature

An impermeable outer membrane and multidrug efflux pumps work in concert to provide Gram-negative bacteria with intrinsic resistance against many antibiotics

— the same barrier that limits mupirocin's Gram-negative reach.

Susceptible (clinically relevant / label-supported activity)

Organism	Category	Notes
Staphylococcus aureus (incl. MRSA)	Gram-positive cocci	Primary target; basis for impetigo and nasal decolonization indications
Staphylococcus epidermidis / coagulase-negative staph	Gram-positive cocci	In-vitro active
Staphylococcus saprophyticus	Gram-positive cocci	In-vitro active
Streptococcus pyogenes (Group A)	Gram-positive cocci	Impetigo pathogen; label-supported
Streptococcus spp. (other β-hemolytic)	Gram-positive cocci	Generally susceptible
Haemophilus influenzae	Gram-negative	One of the few Gram-negatives with useful MICs
Neisseria spp. (gonorrhoeae, meningitidis)	Gram-negative	In-vitro susceptible
Moraxella catarrhalis	Gram-negative	In-vitro susceptible
Pasteurella multocida	Gram-negative	In-vitro susceptible

Not reliably susceptible / intrinsically resistant

Organism / group	Category	Basis for resistance
Enterobacterales (E. coli, Klebsiella, Enterobacter, Proteus, Serratia)	Gram-negative bacilli	Outer-membrane impermeability + efflux; poor IleRS access
Pseudomonas aeruginosa	Gram-negative bacilli	Intrinsically resistant (efflux/permeability)
Stenotrophomonas / Acinetobacter	Gram-negative bacilli	Poor activity
Enterococcus spp. (E. faecalis, E. faecium)	Gram-positive cocci	Insensitive IleRS; unreliable activity
Corynebacterium spp.	Gram-positive bacilli	Variable/poor
Anaerobes (Bacteroides, Clostridium, etc.)	Anaerobic	Outside spectrum
Micrococcus spp.	Gram-positive cocci	Poor activity
Fungi (Candida etc.)	—	No activity (antibacterial only)

Practical resistance caveats (relevant to your CMC/clinical context)

Low-level resistance (MIC 8–256 µg/mL) arises from point mutations in the native chromosomal ileS; high-level resistance (MIC ≥512 µg/mL) is plasmid-mediated via mupA (ileS-2) / mupB, encoding a mupirocin-insensitive IleRS. High-level resistance predicts decolonization failure and is the key surveillance concern in S. aureus/MRSA programs.
The listed "susceptible" Gram-negatives (Haemophilus, Neisseria, Moraxella, Pasteurella) are in-vitro observations; mupirocin's approved use is topical Gram-positive skin/nasal indications, not systemic Gram-negative therapy.
The applicable interpretive breakpoints are the mupirocin-specific criteria in the FDA labeling / CLSI susceptibility standards; confirm against the current label revision for any regulatory submission.

If you want this scoped to a specific product (e.g., Bactroban ointment vs. cream vs. Centany nasal) with the exact label MIC breakpoint text and the current SPL revision date pulled verbatim for a submission, tell me which NDC/label and I'll extract the Microbiology section directly.

This is research context, not medical advice.

Let me ground this in the antifungal literature and OTC label data, since tinea faciei and tinea incognito have importantly different treatment implications.

Short answer: it depends on which entity you actually have. For uncomplicated tinea faciei, OTC topical allylamines/azoles can work — but for tinea incognito (steroid-modified tinea), OTC self-treatment is generally not adequate and can worsen the disease, and the emergence of Trichophyton indotineae has made even "textbook" topical monotherapy unreliable.

The two entities are not the same treatment problem

Tinea faciei = dermatophytosis of glabrous facial skin. Site-directed topical antifungals are the standard first line for limited superficial dermatophyte infection Therapeutic strategies depend upon the affected body site... Topical antifungals remain the most commonly recommended treatment for limited disease.
Tinea incognito / tinea incognita = dermatophytosis whose morphology has been altered (and typically worsened) by prior topical/systemic corticosteroid use, causing misdiagnosis. The defining pathogenic feature is that steroid immunosuppression locally blunts inflammation, letting the fungus spread — so continuing any steroid-containing OTC product is counterproductive The 2024 case-study review frames it as steroid-driven masking that must be "unmasked" and the steroid stopped.

That distinction matters because a very common driver of tinea incognito on the face is OTC steroid or steroid-combination creams. There is a documented tinea faciei case where facial disease was self-treated with OTC products including clobetasol, producing steroid rosacea on top of the infection — i.e., the wrong OTC choice actively caused harm.

What OTC agents are effective — and their limits

OTC topical antifungals available in the US that have genuine anti-dermatophyte activity:

OTC agent	Class	Anti-dermatophyte activity	Practical note for face
Terbinafine 1% (Lamisil AT)	Allylamine	Fungicidal, most potent OTC option vs dermatophytes	Best OTC choice for uncomplicated tinea faciei; short courses
Clotrimazole 1%	Azole	Fungistatic	Effective but slower; longer courses needed
Miconazole 2%	Azole	Fungistatic	Similar to clotrimazole
Tolnaftate 1% (Tinactin)	Thiocarbamate	Active vs dermatophytes	Reasonable but weaker than terbinafine
Butenafine 1% (Lotrimin Ultra)	Benzylamine (allylamine-like)	Fungicidal	Comparable to terbinafine

Ketoconazole is a reasonable topical azole for facial dermatophytosis and there is a recent case of infantile tinea faciei cleared with topical ketoconazole — but note that case was T. indotineae, treated under dermatologic care, not blind OTC self-treatment (US OTC ketoconazole is 1% and marketed for dandruff/seborrhea, not labeled for tinea).

What is NOT appropriate OTC: any azole/steroid combination (e.g., clotrimazole–betamethasone) or standalone hydrocortisone — these are the exact products that convert ordinary tinea into tinea incognito.

Why "just buy an OTC cream" is the wrong framing for these two

Facial skin + diagnostic uncertainty. Tinea faciei is frequently misdiagnosed (mimics rosacea, seborrheic dermatitis, lupus, impetigo — there's a described impetigo-like presentation), so empiric OTC treatment on the face risks treating the wrong disease and delaying KOH/culture confirmation.
Tinea incognito is, by definition, a treatment failure/misdiagnosis state. The correct move is stopping the offending steroid and treating with an adequate antifungal — often systemic (oral terbinafine or itraconazole) because disease is usually more extensive, deeper, and follicular by the time it's recognized. Topical OTC monotherapy is commonly insufficient.
Resistant dermatophytes. T. indotineae now frequently causes extensive, persistent tinea corporis/cruris/faciei and is often terbinafine-resistant due to squalene epoxidase (SQLE) mutations — meaning even the strongest OTC agent can fail, and confirmation plus itraconazole (or susceptibility-guided therapy) may be required. This is an emerging and clinically important issue.

Bottom line

Uncomplicated, correctly-diagnosed tinea faciei: yes — OTC terbinafine 1% (or butenafine) is a reasonable, effective first-line topical; azoles/tolnaftate are alternatives.
Tinea incognito: effectively no reliable OTC cure — it requires stopping the steroid, mycologic confirmation, and usually clinician-directed (often oral) antifungal therapy; treating it blind with OTC creams, and especially any steroid-containing OTC product, tends to prolong or worsen it.
Any facial rash not clearing promptly, atypical, or previously steroid-treated: get KOH/culture (and consider T. indotineae resistance testing) before assuming an OTC agent will work.

This is research context, not medical advice — diagnosis of tinea faciei vs. tinea incognito and any decision to use topical vs. oral therapy should be made by a clinician with mycologic confirmation.

Research session