Bacitracin Versus Mupirocin for Staphylococcus aureus Nasal Colonization •

ArticleinInfection Control and Hospital Epidemiology 20(5):351-3 · June 1999with22 Reads
DOI: 10.1086/501633 · Source: PubMed
Abstract
We performed a randomized prospective study of 5-day treatment with topical mupirocin or bacitracin for the elimination of Staphylococcus aureus nasal colonization in healthcare workers (HCWs). Nasal cultures were obtained from 141 HCWs, 37 (26%) of whom showed S. aureus. After 72 to 96 hours of treatment, the organism was eradicated in 15 (94%) of 16 by mupirocin and in 8 (44%) of 18 by bacitracin (P = .0031). Similar efficacy was demonstrated at 30 days. Mupirocin may be more effective than bacitracin for eradication of S. aureus in healthy HCWs.
    • "Mupirocin is the most frequently studied molecule for the eradication of nasal S. aureus carriage and its efficacy has been convincingly demonstrated in randomized double-blind trials 21—23 (All level of evidence 1). Another randomized double-blind trial showed it to be more effective than bacitracin [24] (Level of evidence: 1), and it proved more effective than Neomycin sulfate in a lower level study [25] (Level of evidence: 3). Comparable results were found in an open trial against an association of topical fusidic acid and oral trimethoprim—sulfamethoxazole [26] (Level of evidence: 2). "
    [Show abstract] [Hide abstract] ABSTRACT: Staphylococcus aureus est l’agent pathogène le plus fréquemment rencontré dans les infections sur matériel orthopédique et diverses stratégies sont employées pour limiter le risque de transmission et donc d’infection lors des gestes chirurgicaux.
    Article · Oct 2013
    • "Mupirocin is the most frequently studied molecule for the eradication of nasal S. aureus carriage and its efficacy has been convincingly demonstrated in randomized double-blind trials 21—23 (All level of evidence 1). Another randomized double-blind trial showed it to be more effective than bacitracin [24] (Level of evidence: 1), and it proved more effective than Neomycin sulfate in a lower level study [25] (Level of evidence: 3). Comparable results were found in an open trial against an association of topical fusidic acid and oral trimethoprim—sulfamethoxazole [26] (Level of evidence: 2). "
    [Show abstract] [Hide abstract] ABSTRACT: Staphylococcus aureus is the pathogen most frequently implicated in infection on orthopedic hardware; various strategies are deployed to limit the risk of transmission and surgical infection. The present study is based on a meta-analysis assessing firstly the relationship between nasal carriage of S. aureus and the development of osteo-articular infection and secondly current methods of decolonization. The meta-analysis showed increased risk of surgical site infection in case of nasal carriage of S. aureus: OR=5.92, 95% CI [1.15-30.39]; P=0.033. For cross-transmission, a scientifically proven reduction in surgical site S. aureus levels is ensured by associated mupirocin and 2% chlorhexidine antiseptic solution in subjects with positive nasal screening results for all surgical procedures taken together; the reduction was not, however, significant in the orthopedic surgery subgroup. The meta-analysis confirmed these findings: OR=0.60, 95% CI [0.34-1.06]; P=0.08. The literature review confirmed that nasal carriage of S. aureus is a major risk factor for surgical site infection. The efficacy of eradication could not be demonstrated for orthopedic surgery as samples were too small. The positive trend found, however, should encourage further studies with sufficient power and risk/benefit should meanwhile be assessed on a case-by-case basis. Level 2. Meta-analysis.
    Article · Aug 2013
    • "Other topical agents were investigated less often. Bacitracin nasal ointment only eradicated carriage in 10 (29%) of 34 MRSA and MSSA carriers at 1 week after treatment (range, 13%–44%) [16, 30], and tea tree oil eliminated MRSA carriage in 46 (44%) of 110 carriers at 2 weeks after treatment [34]. Compared with mupirocin, estimated pooled RRs of treatment failure of bacitracin and tea tree oil at the end of treatment was 1.88 (range, 0.57–6.15; "
    [Show abstract] [Hide abstract] ABSTRACT: A systematic review was performed to determine the effectiveness of different approaches for eradicating methicillin-resistant Staphylococcus aureus carriage. Twenty-three clinical trials were selected that evaluated oral antibiotics (7 trials), topically applied antibiotics (12 trials), or both (4 trials). Because of clinical heterogeneity, quantitative analysis of all studies was deemed to be inappropriate, and exploratory subgroup analyses were performed for studies with similar study populations, methods, and targeted bacteria. The estimated pooled relative risk of treatment failure 1 week after short-term nasal mupirocin treatment, compared with placebo, was 0.10 (range, 0.07–0.14). There was low heterogeneity between study outcomes, and effects were similar for patients and healthy subjects, as well as in studies that included only methicillin-susceptible S. aureus carriers or both methicillin-susceptible S. aureus and methicillin-resistant S. aureus carriers. The development of drug resistance during treatment was reported in 1% and 9% of patients receiving mupirocin and oral antibiotics, respectively. Short-term nasal application of mupirocin is the most effective treatment for eradicating methicillin-resistant S. aureus carriage, with an estimated success of rate of 90% 1 week after treatment and ∼60% after a longer follow-up period.
    Full-text · Article · Mar 2009
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