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Previous Volume 346:1871-1877 June 13, 2002 Number 24 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Farr, B. M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background 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.

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.

Source Information

From the University of Iowa Colleges of Medicine and Public Health, Iowa City (T.M.P., J.J.C., R.P.W., M.B.Z., M.A.P., D.S., J.T., L.A.H.); the University of Iowa Hospitals and Clinics, Iowa City (L.A.H.); GlaxoSmithKline, Collegeville, Pa. (P.P.F.); and the Johns Hopkins Medical Institutions, Baltimore (T.M.P.).

Address reprint requests to Dr. Perl at the Johns Hopkins Medical Institutions, Division of Infectious Diseases and Department of Hospital Epidemiology and Infection Control, 425 Osler, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287.

Full Text of this Article

Related Letters:

Intranasal Mupirocin to Prevent Postoperative Infections
von Eiff C., Kipp F., Becker K., Delgado-Hachmeister J. E., Graviss E. A., Perl T. M., Zimmerman M. B.
Extract | Full Text | PDF  
N Engl J Med 2002; 347:1207-1208, Oct 10, 2002. Correspondence

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