BACKGROUND: HIV-positive patients at HELP/PSI, Inc, an in-patient drug rehabilitation center, had a high baseline prevalence of Staphylococcus aureus colonization (49%) and incidence of infection (17%) in a previous year-long study. METHODS: A randomized, double-blinded, placebo-controlled study was conducted to determine whether repeated nasal application of mupirocin ointment would decrease the odds of S. aureus nasal colonization in 100 HELP/PSI patients over an 8-month period. A 5-day course of study drug was given monthly, and colonization was assessed at baseline and 1 month after each treatment. S. aureus infection was a secondary outcome. RESULTS: In repeated-measures analysis, mupirocin reduced the odds of monthly S. aureus nasal colonization by 83% compared with placebo [adjusted odds ratio (ORadj) = 0.17; P < 0.0001]. Subjects colonized at study entry had a 91% reduction in subsequent colonization (ORadj = 0.09; P < 0.0001). Mupirocin also suppressed S. aureus colonization in subjects not colonized at baseline (ORadj = 0.23; P = 0.006). There was no difference in infection rates between the mupirocin and placebo groups (hazard ratio = 0.49, P = 0.29). CONCLUSIONS: Monthly application of nasal mupirocin significantly decreased S. aureus colonization in HIV patients in residential drug rehabilitation. Monthly mupirocin application has a potential role in long-term care settings or in HIV-positive patients with high rates of S. aureus colonization and infection.
RCT Entities:
BACKGROUND:HIV-positivepatients at HELP/PSI, Inc, an in-patient drug rehabilitation center, had a high baseline prevalence of Staphylococcus aureus colonization (49%) and incidence of infection (17%) in a previous year-long study. METHODS: A randomized, double-blinded, placebo-controlled study was conducted to determine whether repeated nasal application of mupirocin ointment would decrease the odds of S. aureus nasal colonization in 100 HELP/PSI patients over an 8-month period. A 5-day course of study drug was given monthly, and colonization was assessed at baseline and 1 month after each treatment. S. aureus infection was a secondary outcome. RESULTS: In repeated-measures analysis, mupirocin reduced the odds of monthly S. aureus nasal colonization by 83% compared with placebo [adjusted odds ratio (ORadj) = 0.17; P < 0.0001]. Subjects colonized at study entry had a 91% reduction in subsequent colonization (ORadj = 0.09; P < 0.0001). Mupirocin also suppressed S. aureus colonization in subjects not colonized at baseline (ORadj = 0.23; P = 0.006). There was no difference in infection rates between the mupirocin and placebo groups (hazard ratio = 0.49, P = 0.29). CONCLUSIONS: Monthly application of nasal mupirocin significantly decreased S. aureus colonization in HIVpatients in residential drug rehabilitation. Monthly mupirocin application has a potential role in long-term care settings or in HIV-positivepatients with high rates of S. aureus colonization and infection.
Authors: R B Roberts; M Chung; H de Lencastre; J Hargrave; A Tomasz; D P Nicolau; J F John; O Korzeniowski Journal: Microb Drug Resist Date: 2000 Impact factor: 3.431
Authors: Christian Cespedes; Maureen Miller; Bianca Quagliarello; Peter Vavagiakis; Robert S Klein; Franklin D Lowy Journal: J Clin Microbiol Date: 2002-07 Impact factor: 5.948
Authors: Lucy E Wilson; David L Thomas; Jacqueline Astemborski; Terri L Freedman; David Vlahov Journal: J Infect Dis Date: 2002-05-31 Impact factor: 5.226
Authors: Lona Mody; Carol A Kauffman; Shelly A McNeil; Andrzej T Galecki; Suzanne F Bradley Journal: Clin Infect Dis Date: 2003-11-06 Impact factor: 9.079
Authors: Trish M Perl; Joseph J Cullen; Richard P Wenzel; M Bridget Zimmerman; Michael A Pfaller; Deborah Sheppard; Jennifer Twombley; Pamela P French; Loreen A Herwaldt Journal: N Engl J Med Date: 2002-06-13 Impact factor: 91.245
Authors: J Chase McNeil; Eric Y Kok; Jesus G Vallejo; Judith R Campbell; Kristina G Hulten; Edward O Mason; Sheldon L Kaplan Journal: Antimicrob Agents Chemother Date: 2015-12-14 Impact factor: 5.191
Authors: Dennis de Carvalho Ferreira; Glaucilene Rodrigues da Silva; Fernanda Sampaio Cavalcante; Flavia Lima do Carmo; Leonardo Alexandre Fernandes; Suelen Moreira; Mauro Romero Leal Passos; Ana Paula Vieira Colombo; Katia Regina Netto dos Santos Journal: Clinics (Sao Paulo) Date: 2014-11 Impact factor: 2.365