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Rationale:
- Carriage of S. aureus may lead to subsequent infection in the patient as well as unwitting spread to others by contact.
- Although carriage can be eradicated, in many cases relapses do occur.
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Evidence:
- Carriage is effectively eradicated by mupirocin and chlorhexidine washes (25).
- Relapse frequently occurs some months after treatment (28).
- According to a meta-analysis, mupirocin ointment reduced the rate of subsequent S. aureus infection compared to placebo. A subgroup analysis of surgical trials also showed a reduction in infections associated with
mupirocin compared to placebo (156).
- Among isolates of MRSA from 32 hospitals in the Canadian Nosocomial Infection Surveillance Program during the 10-year period
from 1995 through 2004, 12% were resistant to mupirocin (157).
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Comments:
- The use of mupirocin ointment to eradicate MRSA colonization may lead to mupirocin resistance.
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Dennis L. Stevens, PhD, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Lawrence J. Eron, MD, FACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Cellulitis and Soft Tissue Infections
> Drug Therapy
