Efficacy and safety of topical lysostaphin treatment of persistent nasal carriage of Staphylococcus aureus.

The efficacy of lysostaphin nasal spray and Neosporin ointment (Burroughs Wellcome & Co.) in altering nasal carriage of Staphylococcus aureus was studied with persistent carriers in an institution for mentally retarded children and adults. Treatment for 5 days with either agent significantly reduced carriage rates. This effect persisted through the 5th day after therapy with lysostaphin but not with Neosporin. By the 11th day after therapy, carriage rates in the treatment and control groups were not significantly different. Except for a single immediate wheal and flair skin test reaction, no other evidence of adverse reactions to topical lysostaphin was detected. No consistent changes in hemagglutination-inhibition titers to lysostaphin were observed after therapy. Lysostaphin appears to be slightly more effective than conventional topical antimicrobial therapy in reducing nasal carriage of staphylococci in this rigorously defined population of persistent carriers.