A 1-YEAR TRIAL OF NASAL MUPIROCIN IN THE PREVENTION OF RECURRENT STAPHYLOCOCCAL NASAL COLONIZATION AND SKIN INFECTION

Background: The usefulness of nasal mupirocin in preventing recurrent staphylococcal nasal colonization and skin infection has been examined in immunodeficient patients and in healthy staphylococcal carriers bu t not in immunocompetent staphylococcal carriers who experience recurr ent skin infections. We studied 34 such patients. Methods: After an in itial 5-day course of nasal mupirocin ointment for all patients, 17 pa tients continued to apply a S-day course of nasal mupirocin every mont h for 1 year, and the other 17 patients applied a placebo ointment. Na sal cultures were obtained monthly, and all episodes of skin infection were recorded. Results: The overall number of positive nasal cultures was 22 in the mupirocin group and 83 in the placebo group (P<.001), a nd the number of skin infections was 26 and 62, respectively (P<.002). Eight of the 17 mupirocin-treated patients but only 2 in the placebo group remained free of positive staphylococcal nasal cultures. One of the 10 patients who were free of colonization during the 12-month trea tment period had skin infections, in contrast to all 24 of the patient s with positive cultures (P<.01). Staphylococci resistant to mupirocin were observed in 1 patient. No adverse effects were reported. Conclus ion: A monthly application of mupirocin ointment in staphylococcal car riers reduces the incidence of nasal colonization, which in turn lower s the risk of skin infection.