TY - JOUR
T1 - Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections
AU - Perl, Trish M.
AU - Cullen, Joseph J.
AU - Wenzel, Richard P.
AU - Zimmerman, M. Bridget
AU - Pfaller, Michael A.
AU - Sheppard, Deborah
AU - Twombley, Jennifer
AU - French, Pamela P.
AU - Herwaldt, Loreen A.
PY - 2002/6/13
Y1 - 2002/6/13
N2 - Background: Patients with nasal carriage of Staphylococcus aureus have an increased risk of surgicalsite infections caused by that organism. Treatment with mupirocin ointment can reduce the rate of nasal carriage and may prevent postoperative S. aureus infections. Methods: 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. Results: 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). Conclusions 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.
AB - Background: Patients with nasal carriage of Staphylococcus aureus have an increased risk of surgicalsite infections caused by that organism. Treatment with mupirocin ointment can reduce the rate of nasal carriage and may prevent postoperative S. aureus infections. Methods: 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. Results: 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). Conclusions 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.
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U2 - 10.1056/NEJMoa003069
DO - 10.1056/NEJMoa003069
M3 - Article
C2 - 12063371
AN - SCOPUS:0037071793
SN - 0028-4793
VL - 346
SP - 1871
EP - 1877
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 24
ER -