MUPIROCIN OINTMENT WITH AND WITHOUT CHLORHEXIDINE BATHS IN THE ERADICATION OF STAPHYLOCOCCUS-AUREUS NASAL CARRIAGE IN NURSING-HOME RESIDENTS

Background: Mupirocin ointment has been shown to be effective in eradi cating Staphylococcus aureus nasal carriage in residents of a long-ter m care facility. Antiseptic soaps have been used as adjunct to this th erapy. We compared the efficacy of short-term intranasal mupirocin oin tment with and without chlorhexidine baths in the eradication of S. au reus nasal carriage with follow-up for 12 weeks. Methods: Residents in four nursing homes known to have endemic methicillin-resistant S. aur eus were screened for nasal carriage of S. aureus. Residents who had a nterior nares cultures positive for S. aureus on two separate occasion s were divided into two groups. Both groups received intranasal mupiro cin ointment twice daily for 5 days and one group also received chlorh exidine baths for the first 3 days. Cultures of anterior nares, axilla , and groins were performed before treatment and 1 day and 1, 4, 8, an d 12 weeks after treatment. Results: After treatment, S. aureus nasal carriage was eradicated in all residents. Recolonization with S. aureu s had occurred at 12 weeks in 24% of residents receiving mupirocin oin tment alone (6/25) and in 15% of residents receiving mupirocin ointmen t plus chlorhexidine baths (4/27). Conclusions: A short course of mupi rocin ointment was effective in eradicating nasal carriage of S. aureu s in nursing home residents. There were no statistical differences in efficacy between the two regimens with respect to the eradication of n asal carriage and prevention of recolonization with S. aureus.