• Ann. Intern. Med. · Mar 2004

    Randomized Controlled Trial Multicenter Study Clinical Trial

    Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study.

    • Heiman F L Wertheim, Margreet C Vos, Alewijn Ott, Andreas Voss, Jan A J W Kluytmans, Christina M J E Vandenbroucke-Grauls, Marlene H M Meester, Peter H J van Keulen, and Henri A Verbrugh.
    • Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands. h.wertheim@erasmusmc.nl
    • Ann. Intern. Med. 2004 Mar 16;140(6):419-25.

    BackgroundStaphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical patients.ObjectiveTo assess the efficacy of mupirocin prophylaxis in preventing nosocomial S. aureus infections in nonsurgical patients.DesignRandomized, double-blind, placebo-controlled trial.Setting3 tertiary care academic hospitals and 1 nonacademic hospital.Patients1602 culture-proven S. aureus carriers hospitalized in nonsurgical departments.InterventionTherapy with mupirocin 2% nasal ointment (n = 793) or placebo ointment (n = 809), twice daily for 5 days, started 1 to 3 days after admission.MeasurementsNosocomial S. aureus infections according to defined criteria, in-hospital mortality, duration of hospitalization, and time to nosocomial S. aureus infection. Staphylococcus aureus isolates were genotyped to assess whether infection was caused by endogenous strains.ResultsThe mupirocin and placebo groups did not statistically differ in the rates of nosocomial S. aureus infections (mupirocin, 2.6%; placebo, 2.8%; risk difference, 0.2 percentage point [95% CI, -1.5 to 1.9 percentage points]), mortality (mupirocin, 3.0%; placebo, 2.8%; risk difference, -0.2 percentage point [CI, -1.9 to 1.5 percentage points]), or duration of hospitalization (median for both, 8 days). However, time to nosocomial S. aureus infection was decreased in the mupirocin group from 12 to 25 days (P > 0.2). A total of 77% of S. aureus nosocomial infections were endogenous.LimitationsA few infections in both groups may have been missed because investigators assessed a patient for infection only if microbiology culture results were positive for S. aureus.ConclusionRoutine culture for S. aureus nasal carriage at admission and subsequent mupirocin application does not provide effective prophylaxis against nosocomial S. aureus infections in nonsurgical patients.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…