Elimination of Staphylococcus aureus Nasal Carriage in Health Care Workers: Analysis of Six Clinical Trials with Calcium Mupirocin Ointment

Six double-blind, independently randomized studies evaluated the efficacy and safety of calcium mupirocin ointment in eliminating nasal carriage of Staphylococcus aureus among health care workers. Healthy volunteers with stable nasal carriage of S. aureus (n = 339) received either calcium mupirocin...

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Bibliographic Details
Published in:	Clinical infectious diseases Vol. 17; no. 3; pp. 466 - 474
Main Authors:	Doebbeling, Bradley N., Breneman, Debra L., Neu, Harold C., Aly, Raza, Yangco, Bienvenido G., Holley, H. Preston, Marsh, Regina J., Pfaller, Michael A., McGowan, John E., Scully, Brian E., Reagan, David R., Wenzel, Richard P.
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Chicago, IL The University of Chicago Press 01-09-1993 University of Chicago Press
Subjects:	Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Calcium Clinical Infectious Disease Articles Clinical trials Human experimentation Infections Medical personnel Medical sciences Ointments Pharmacology. Drug treatments Placebos Staphylococcus Staphylococcus aureus Symptoms Staphylococcus aureus Human Calcium Health staff Infection Antibiotic Chemotherapy Treatment Bacteriosis Bacteria Micrococcales Clinical trial Micrococcaceae Carrier Staphylococcal infection Intranasally administration Staphylococcus aureus
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Summary:	Six double-blind, independently randomized studies evaluated the efficacy and safety of calcium mupirocin ointment in eliminating nasal carriage of Staphylococcus aureus among health care workers. Healthy volunteers with stable nasal carriage of S. aureus (n = 339) received either calcium mupirocin ointment (n = 170) or an identical placebo ointment (n = 169) intranasally for 5 days. Nasal carriage was eliminated 48–96 hours after completion of treatment in 130 (91%) of 143 evaluable volunteers receiving mupirocin but in only 8 (6%) of 142 evaluable volunteers receiving placebo. The 85% crude difference represents a 90% pooled (adjusted) estimate of the risk difference (95% confidence interval, 0.86–0.95) and a risk ratio of 16 (P < .0001). This effect of treatment with mupirocin was observed consistently (risk ratio, 8–32) in all six centers. In addition, 96 of the 130 mupirocin-treated volunteers and 1 of the 8 placebo-treated volunteers who were culture-negative at the end of therapy remained free of S. aureus 4 weeks after treatment. Adverse events in each treatment arm were mild and equally frequent. These data, consistent across six institutions, demonstrate that calcium mupirocin ointment administered intranasally for 5 days is safe and effective in eliminating stable nasal carriage of S. aureus.
Bibliography:	ark:/67375/HXZ-J02RLWR2-P Reprints or correspondence: Dr. Bradley N. Doebbeling, Department of Internal Medicine, C41L GH, The University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, Iowa 52242-1081. Members of the Mupirocin Collaborative Study Group: Richard J. Hollis, Alison K. Houston, and Carol T. Sheetz, University of Iowa College of Medicine, Iowa City; Vivian Berger and Rosemary Chaney, University of Cincinnati Medical Center, Cincinnati; F. Briones and J. Gu, Columbia University, New York; Charlene Bayles, University of California, San Francisco; and Michael Miller, Beverly Metchock, and Gary Hancock, Emory University School of Medicine and the Centers for Disease Control and Prevention, Atlanta. istex:4CEB41736AC5B161C8A05F12EF96564402A38972 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1058-4838 1537-6591
DOI:	10.1093/clinids/17.3.466