T T Poovelikunnel1, G Gethin2, D Solanki3, E McFadden4, M Codd5, H Humphreys6. 1. Infection Prevention and Control Department, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland. Electronic address: toneythomas@beaumont.ie. 2. School of Nursing and Midwifery, Áras Moyola, National University of Ireland, Galway, Ireland. 3. Department of Pharmacy, Beaumont Hospital, Dublin, Ireland. 4. Microbiology Department, Beaumont Hospital, Dublin, Ireland. 5. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. 6. Infection Prevention and Control Department, Beaumont Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
Abstract
BACKGROUND:Mupirocin is used specifically for the eradication of nasal meticillin-resistant Staphylococcus aureus (MRSA), but increasing mupirocin resistance restricts its repeated use. The antibacterial effects of manuka honey have been established in vitro; antibacterial activity of other honeys has also been reported. AIM: To describe the learning experience from a randomized controlled trial (RCT) comparing the efficacy of medical-grade honey (MGH) with mupirocin 2% for the eradication of nasal MRSA. METHODS:Patients colonized in the nose with MRSA and age≥18 years were recruited. Participants received either one or two courses of MGH or mupirocin 2%, three times per day for five consecutive days. FINDINGS: The proportion of patients who were decolonized after one or two courses of treatment was not significantly different between MGH [18/42; 42.8%; 95% confidence interval (CI): 27.7-59.0] and mupirocin 2% (25/44; 56.8%; 95% CI: 41.0-71.7). Non-nasal MRSA colonization was significantly associated with persistent nasal colonization (odds ratio: 5.186; 95% CI: 1.736-5.489; P = 0.003). The rate of new acquisition of mupirocin resistance was 9.75%. CONCLUSION: Although not significant, a decolonization rate of 42.8% for MGH was impressive. Our findings suggest that this strategy, which has the potential to combat antimicrobial resistance, should be assessed in similar but larger studies.
RCT Entities:
BACKGROUND:Mupirocin is used specifically for the eradication of nasal meticillin-resistant Staphylococcus aureus (MRSA), but increasing mupirocin resistance restricts its repeated use. The antibacterial effects of manuka honey have been established in vitro; antibacterial activity of other honeys has also been reported. AIM: To describe the learning experience from a randomized controlled trial (RCT) comparing the efficacy of medical-grade honey (MGH) with mupirocin 2% for the eradication of nasal MRSA. METHODS:Patients colonized in the nose with MRSA and age ≥18 years were recruited. Participants received either one or two courses of MGH or mupirocin 2%, three times per day for five consecutive days. FINDINGS: The proportion of patients who were decolonized after one or two courses of treatment was not significantly different between MGH [18/42; 42.8%; 95% confidence interval (CI): 27.7-59.0] and mupirocin 2% (25/44; 56.8%; 95% CI: 41.0-71.7). Non-nasal MRSA colonization was significantly associated with persistent nasal colonization (odds ratio: 5.186; 95% CI: 1.736-5.489; P = 0.003). The rate of new acquisition of mupirocin resistance was 9.75%. CONCLUSION: Although not significant, a decolonization rate of 42.8% for MGH was impressive. Our findings suggest that this strategy, which has the potential to combat antimicrobial resistance, should be assessed in similar but larger studies.
Authors: Toney T Poovelikunnel; Paulo E Budri; Anna C Shore; David C Coleman; Hilary Humphreys; Deirdre Fitzgerald-Hughes Journal: Antimicrob Agents Chemother Date: 2018-08-27 Impact factor: 5.191
Authors: Joy Uwemedimo; Deirdre Fitzgerald-Hughes; Peter Kinnevey; Anna Shore; David Coleman; Hilary Humphreys; Toney Thomas Poovelikunnel Journal: J Infect Prev Date: 2020-06-13