06/13/2002 By Elda Hauschildt
Topical antibiotic treatment is effective in reducing the rate of Staphylococcus aureus infections at surgical sites in a subgroup of patients who are nasal carriers of S. aureus. Researchers from the University of Iowa in Iowa City and the Johns Hopkins Medical Institutions in Baltimore, Maryland, United States, say prophylactic intranasal application of mupirocin did not significantly reduce the rate of S. aureus surgical-site infections overall. However, this randomised, double-blind placebo-controlled trial indicated found that prophylactic use significantly decreased the rate of all nosocomial infections among patients who are S. aureus carriers.
They state: “We conclude that mupirocin therapy is safe, has a protective effect among nasal carriers of S. aureus and is a reasonable adjuvant agent to prevent such infections in carriers after surgery.” Study participants involved 4,030 patients undergoing general, gynaecologic, neurologic or cardiothoracic surgery, 3,864 were included in intention-to-treat analysis. Overall, 2.3 percent of patients receiving mupirocin and 2.4 of those receiving placebo developed S. aureus infections at surgical sites.
A total of 891 participants (23.1 percent of those completing the study) had S. aureus in their anterior nares. Researchers randomised 444 of these patients to mupirocin and 447 to placebo.
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