OBJECTIVE: To review the evidence evaluating perioperative intranasal mupirocin for the prevention of surgical-site infections according to type of surgical procedure. DESIGN: Systematic review and meta-analysis of published clinical trials. SETTING: Studies included were either randomized clinical trial or prospective trials at a single institution that measured outcomes both before and after an institution-wide intervention (before-after trial). In all studies, intervention and control groups differed only by the use of perioperative intranasal mupirocin in the intervention group. PATIENTS: Patients undergoing general or nongeneral surgery (eg, cardiothoracic surgery, orthopedic surgery, and neurosurgery). MAIN OUTCOME MEASURE: Risk of surgical-site infection following perioperative intranasal mupirocin versus usual care. RESULTS: Three randomized and four before-after trials met the inclusion criteria. No reduction in surgical-site infection rate was seen in randomized general surgery trials (summary estimates: 8.4% in the mupirocin group and 8.1% in the control group; relative risk [RR], 1.04; 95% confidence interval [CI95], 0.81 to 1.33). In nongeneral surgery, the use of mupirocin was associated with a reduction in surgical-site infection in randomized trials (summary estimates: 6.0% in the mupirocin group and 7.6% in the control group; RR, 0.80; CI95, 0.58 to 1.10) and in before-after trials (summary estimates: 1.7% in the mupirocin group and 4.1% in the control group; RR, 0.40; CI95, 0.29 to 0.56). CONCLUSIONS: Perioperative intranasal mupirocin appears to decrease the incidence of surgical-site infection when used as prophylaxis in nongeneral surgery. Given its low risk and low cost, use of perioperative intranasal mupirocin should be considered in these settings.
OBJECTIVE: To review the evidence evaluating perioperative intranasal mupirocin for the prevention of surgical-site infections according to type of surgical procedure. DESIGN: Systematic review and meta-analysis of published clinical trials. SETTING: Studies included were either randomized clinical trial or prospective trials at a single institution that measured outcomes both before and after an institution-wide intervention (before-after trial). In all studies, intervention and control groups differed only by the use of perioperative intranasal mupirocin in the intervention group. PATIENTS: Patients undergoing general or nongeneral surgery (eg, cardiothoracic surgery, orthopedic surgery, and neurosurgery). MAIN OUTCOME MEASURE: Risk of surgical-site infection following perioperative intranasal mupirocin versus usual care. RESULTS: Three randomized and four before-after trials met the inclusion criteria. No reduction in surgical-site infection rate was seen in randomized general surgery trials (summary estimates: 8.4% in the mupirocin group and 8.1% in the control group; relative risk [RR], 1.04; 95% confidence interval [CI95], 0.81 to 1.33). In nongeneral surgery, the use of mupirocin was associated with a reduction in surgical-site infection in randomized trials (summary estimates: 6.0% in the mupirocin group and 7.6% in the control group; RR, 0.80; CI95, 0.58 to 1.10) and in before-after trials (summary estimates: 1.7% in the mupirocin group and 4.1% in the control group; RR, 0.40; CI95, 0.29 to 0.56). CONCLUSIONS: Perioperative intranasal mupirocin appears to decrease the incidence of surgical-site infection when used as prophylaxis in nongeneral surgery. Given its low risk and low cost, use of perioperative intranasal mupirocin should be considered in these settings.
Authors: Rupak Datta; Atia Shah; Susan S Huang; Eric Cui; Vinh Nguyen; Susan J Welbourne; Kathleen A Quan; Lauri Thrupp Journal: J Clin Microbiol Date: 2013-10-23 Impact factor: 5.948
Authors: D Cal Ham; Isaac See; Shannon Novosad; Matthew Crist; Garrett Mahon; Lucy Fike; Kevin Spicer; Pamela Talley; Andrea Flinchum; Marion Kainer; Alexander J Kallen; Maroya Spalding Walters Journal: J Hosp Infect Date: 2020-04-10 Impact factor: 3.926
Authors: Donna M Hacek; William J Robb; Suzanne M Paule; James C Kudrna; Van Paul Stamos; Lance R Peterson Journal: Clin Orthop Relat Res Date: 2008-03-18 Impact factor: 4.176