Can mupirocin prevent methicillin-resistant Staphylococcus aureus infections?

Heiman Fl Wertheim,Margreet C Vos

doi:10.1186/cc3720

Abstract

In a retrospective study, Dr Muller and colleagues have assessed the efficacy of mupirocin nasal ointment alongside hygienic measures in methicillin-resistant Staphylococcus aureus (MRSA)-positive patients admitted to the intensive care unit (ICU). Their findings, which suggest that intranasal mupirocin can prevent ICU-related MRSA infections, need confirmation in a well-designed clinical trial. In general: early identification, isolation and treatment of all MRSA carriers, including health care workers, and disinfection of contaminated environments, are the main 'ingredients' of an effective MRSA 'search and destroy' program.

Highlights

Muller and colleagues performed a retrospective study in which they compared a 2-year methicillin-resistant Staphylococcus aureus (MRSA) control program with intranasal application of mupirocin, with a 2-year program in which mupirocin was not used
This study is clinically relevant, but the study design used is very susceptible to many biases and their results should be interpreted with caution. Their findings, which suggest that intranasal mupirocin can prevent intensive care unit (ICU)-related MRSA infections, need confirmation in a well-designed clinical trial
Results from recent clinical trials that studied the efficacy of mupirocin nasal ointment in preventing methicillin-susceptible S. aureus (MSSA) infections can be extrapolated to MRSA infections

Summary

Introduction

Muller and colleagues performed a retrospective study in which they compared a 2-year MRSA control program with intranasal application of mupirocin, with a 2-year program in which mupirocin was not used. Their findings, which suggest that intranasal mupirocin can prevent ICU-related MRSA infections, need confirmation in a well-designed clinical trial. Results from recent clinical trials that studied the efficacy of mupirocin nasal ointment in preventing methicillin-susceptible S. aureus (MSSA) infections can be extrapolated to MRSA infections.

Results

Conclusion