COMPARATIVE-STUDY OF MUPIROCIN AND ORAL COTRIMOXAZOLE PLUS TOPICAL FUSIDIC ACID IN ERADICATION OF NASAL CARRIAGE OF METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS

Mupirocin is a topically applied drug that is very active in the eradi cation of nasal carriage of methicillin-resistant Staphylococcus aureu s (MRSA). However, studies designed to compare mupirocin treatment wit h other antimicrobial regimens are lacking. We therefore conducted an open, prospective, randomized, controlled trial to compare the efficac y and safety of mupirocin versus those of oral co-trimoxazole plus top ical fusidic acid (both regimens with a clorhexidine scrub bath) for t he eradication of MRSA from nasal and extranasal carriers of MRSA. The eradication rates with mupirocin and co-trimoxazole plus fusidic acid at 2, 7, 14, 21, 28, and 90 days were 93 and of 93, 100 and 100, 97 a nd 91, 100 and 92, 96 and 95, and 78 and 71%, respectively, for nasal carriage. At 7, 14, and 28 days the eradication rates for extranasal c arriage by the two regimens were 23 and 74, 83 and 76, and 35 and 69%, respectively. The efficacies and safety of both regimens were similar . The MRSA isolates were not resistant to the study drugs either at th e baseline or at follow-up. These results suggest that mupirocin and c o-trimoxazole plus fusidic acid, both used in conjunction with a chlor hexidine soap bath, are equally effective and safe for the eradication of MRSA from nasal and extranasal MRSA carriers. Mupirocin was easier to use but was more expensive.