Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections

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

Research output: Contribution to journalArticle

558 Citations (Scopus)

Abstract

Background: Patients with nasal carriage of Staphylococcus aureus have an increased risk of surgicalsite infections caused by that organism. Treatment with mupirocin ointment can reduce the rate of nasal carriage and may prevent postoperative S. aureus infections. Methods: We conducted a randomized, double-blind, placebo-controlled trial to determine whether intranasal treatment with mupirocin reduces the rate of S. aureus infections at surgical sites and prevents other nosocomial infections. Results: Of 4030 enrolled patients who underwent general, gynecologic, neurologic, or cardiothoracic surgery, 3864 were included in the intention-to-treat analysis. Overall, 2.3 percent of mupirocin recipients and 2.4 percent of placebo recipients had S. aureus infections at surgical sites. Of the 891 patients (23.1 percent of the 3864 who completed the study) who had S. aureus in their anterior nares, 444 received mupirocin and 447 received placebo. Among the patients with nasal carriage of S. aureus, 4.0 percent of those who received mupirocin had nosocomial S. aureus infections, as compared with 7.7 percent of those who received placebo (odds ratio for infection, 0.49; 95 percent confidence interval, 0.25 to 0.92; P=0.02). Conclusions Prophylactic intranasal application of mupirocin did not significantly reduce the rate of S. aureus surgical-site infections overall, but it did significantly decrease the rate of all nosocomial S. aureus infections among the patients who were S. aureus carriers.

Original languageEnglish (US)
Pages (from-to)1871-1877
Number of pages7
JournalNew England Journal of Medicine
Volume346
Issue number24
DOIs
StatePublished - Jun 13 2002

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Mupirocin
Staphylococcus aureus
Infection
Surgical Wound Infection
Nose
Placebos
Intention to Treat Analysis
Cross Infection
Ointments
Nervous System
Odds Ratio

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Perl, T. M., Cullen, J. J., Wenzel, R. P., Zimmerman, M. B., Pfaller, M. A., Sheppard, D., ... Herwaldt, L. A. (2002). Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. New England Journal of Medicine, 346(24), 1871-1877. https://doi.org/10.1056/NEJMoa003069

Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. / Perl, Trish M.; Cullen, Joseph J.; Wenzel, Richard P.; Zimmerman, M. Bridget; Pfaller, Michael A.; Sheppard, Deborah; Twombley, Jennifer; French, Pamela P.; Herwaldt, Loreen A.

In: New England Journal of Medicine, Vol. 346, No. 24, 13.06.2002, p. 1871-1877.

Research output: Contribution to journalArticle

Perl, TM, Cullen, JJ, Wenzel, RP, Zimmerman, MB, Pfaller, MA, Sheppard, D, Twombley, J, French, PP & Herwaldt, LA 2002, 'Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections', New England Journal of Medicine, vol. 346, no. 24, pp. 1871-1877. https://doi.org/10.1056/NEJMoa003069
Perl TM, Cullen JJ, Wenzel RP, Zimmerman MB, Pfaller MA, Sheppard D et al. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. New England Journal of Medicine. 2002 Jun 13;346(24):1871-1877. https://doi.org/10.1056/NEJMoa003069
Perl, Trish M. ; Cullen, Joseph J. ; Wenzel, Richard P. ; Zimmerman, M. Bridget ; Pfaller, Michael A. ; Sheppard, Deborah ; Twombley, Jennifer ; French, Pamela P. ; Herwaldt, Loreen A. / Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. In: New England Journal of Medicine. 2002 ; Vol. 346, No. 24. pp. 1871-1877.
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