Treatment of Staphylococcus aureus colonization and prophylaxis for infection with topical intranasal mupirocin: an evidence-based review.

Abstract

Most Staphylococcus aureus infections are endogenously acquired, and treatment of nasal carriage is one potential strategy for prevention. We critically appraised the published evidence regarding the efficacy of intranasal mupirocin for eradication of S. aureus nasal carriage and for prophylaxis of infection. Sixteen randomized, controlled trials were appraised; 9 trials assessed eradication of colonization as a primary outcome measure, and 7 assessed the reduction in the rate of infection. Mupirocin was generally highly effective for eradication of nasal carriage in the short term. Prophylactic treatment of patients with intranasal mupirocin in large trials did not lead to a significant reduction in the overall rate of infections. However, subgroup analyses and several small studies revealed lower rates of S. aureus infection among selected populations of patients with nasal carriage treated with mupirocin. Although mupirocin is effective at reducing nasal carriage, routine use of topical intranasal mupirocin for infection prophylaxis is not supported by the currently available evidence.

• Authors: Kevin B Laupland, John M Conly
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 37 Issue 7 Pg. 933-8 (Oct 01 2003) ISSN: 1537-6591 [Electronic] United States
• PMID: 13130405 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Bacterial Agents
• Mupirocin

Topics

• Administration, Intranasal
• Anti-Bacterial Agents (therapeutic use)
• Antibiotic Prophylaxis
• Clinical Trials as Topic
• HIV Infections
• Health Occupations
• Humans
• Intensive Care Units
• Mupirocin (therapeutic use)
• Renal Dialysis
• Staphylococcal Infections (prevention & control)
• Staphylococcus aureus (drug effects)