Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections

Trish M Perl; Joseph J Cullen; Richard P Wenzel; M Bridget Zimmerman; Michael A Pfaller; Deborah Sheppard; Jennifer Twombley; Pamela P French; Loreen A Herwaldt; Mupirocin And The Risk Of Staphylococcus Aureus Study Team

doi:10.1056/NEJMoa003069

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Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections

Journal article

Peer reviewed

Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections

Trish M Perl, Joseph J Cullen, Richard P Wenzel, M Bridget Zimmerman, Michael A Pfaller, Deborah Sheppard, Jennifer Twombley, Pamela P French, Loreen A Herwaldt and Mupirocin And The Risk Of Staphylococcus Aureus Study Team

The New England journal of medicine, Vol.346(24), pp.1871-1877

06/13/2002

DOI: 10.1056/NEJMoa003069

PMID: 12063371

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Abstract

Patients with nasal carriage of Staphylococcus aureus have an increased risk of surgical-site infections caused by that organism. Treatment with mupirocin ointment can reduce the rate of nasal carriage and may prevent postoperative S. aureus infections. We conducted a randomized, double-blind, placebo-controlled trial to determine whether intranasal treatment with mupirocin reduces the rate of S. aureus infections at surgical sites and prevents other nosocomial infections. Of 4030 enrolled patients who underwent general, gynecologic, neurologic, or cardiothoracic surgery, 3864 were included in the intention-to-treat analysis. Overall, 2.3 percent of mupirocin recipients and 2.4 percent of placebo recipients had S. aureus infections at surgical sites. Of the 891 patients (23.1 percent of the 3864 who completed the study) who had S. aureus in their anterior nares, 444 received mupirocin and 447 received placebo. Among the patients with nasal carriage of S. aureus, 4.0 percent of those who received mupirocin had nosocomial S. aureus infections, as compared with 7.7 percent of those who received placebo (odds ratio for infection, 0.49; 95 percent confidence interval, 0.25 to 0.92; P=0.02). Prophylactic intranasal application of mupirocin did not significantly reduce the rate of S. aureus surgical-site infections overall, but it did significantly decrease the rate of all nosocomial S. aureus infections among the patients who were S. aureus carriers.

Double-Blind Method

Staphylococcus aureus - isolation & purification

Cross Infection - prevention & control

Humans

Middle Aged

Male

Antibiotic Prophylaxis

Mupirocin - therapeutic use

Administration, Intranasal

Surgical Wound Infection - prevention & control

Anti-Bacterial Agents - therapeutic use

Female

Staphylococcal Infections - prevention & control

Nose - microbiology

Ointments

Details

Title: Subtitle: Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections
Creators: Trish M Perl - University of Iowa Colleges of Medicine and Public Health, Iowa City, USA
Joseph J Cullen
Richard P Wenzel
M Bridget Zimmerman
Michael A Pfaller
Deborah Sheppard
Jennifer Twombley
Pamela P French
Loreen A Herwaldt
Mupirocin And The Risk Of Staphylococcus Aureus Study Team
Resource Type: Journal article
Publication Details: The New England journal of medicine, Vol.346(24), pp.1871-1877
DOI: 10.1056/NEJMoa003069
PMID: 12063371
NLM abbreviation: N Engl J Med
ISSN: 0028-4793
eISSN: 1533-4406
Publisher: United States
Language: English
Date published: 06/13/2002
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Biostatistics; Surgery; Radiation Oncology; Internal Medicine
Record Identifier: 9983997468402771

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