title: Elimination of Staphylococcus aureus nasal carriage in health care workers: analysis of six clinical trials with calcium mupirocin ointment. The Mupirocin Collaborative Study Group.
abstract: Six double-blind, independently randomized studies evaluated the efficacy and safety of calcium mupirocin ointment in eliminating nasal carriage of Staphylococcus aureus among health care workers. Healthy volunteers with stable nasal carriage of S. aureus (n = 339) received either calcium mupirocin ointment (n = 170) or an identical placebo ointment (n = 169) intranasally for 5 days. Nasal carriage was eliminated 48-96 hours after completion of treatment in 130 (91%) of 143 evaluable volunteers receiving mupirocin but in only 8 (6%) of 142 evaluable volunteers receiving placebo. The 85% crude difference represents a 90% pooled (adjusted) estimate of the risk difference (95% confidence interval, 0.86-0.95) and a risk ratio of 16 (P < .0001). This effect of treatment with mupirocin was observed consistently (risk ratio, 8-32) in all six centers. In addition, 96 of the 130 mupirocin-treated volunteers and 1 of the 8 placebo-treated volunteers who were culture-negative at the end of therapy remained free of S. aureus 4 weeks after treatment. Adverse events in each treatment arm were mild and equally frequent. These data, consistent across six institutions, demonstrate that calcium mupirocin ointment administered intranasally for 5 days is safe and effective in eliminating stable nasal carriage of S. aureus.
authors.affiliation: Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242-1081.
authors.forename: B N
authors.initials: BN
authors.lastname: Doebbeling
authors.forename: D L
authors.initials: DL
authors.lastname: Breneman
authors.forename: H C
authors.initials: HC
authors.lastname: Neu
authors.forename: R
authors.initials: R
authors.lastname: Aly
authors.forename: B G
authors.initials: BG
authors.lastname: Yangco
authors.forename: H P
authors.initials: HP
authors.lastname: Holley
authors.forename: R J
authors.initials: RJ
authors.lastname: Marsh
authors.forename: M A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: J E
authors.initials: JE
authors.lastname: McGowan
authors.forename: B E
authors.initials: BE
authors.lastname: Scully
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000008:administration & dosage / Q000627:therapeutic use*; D009297:Nasal Mucosa / Q000382:microbiology*; D009824:Ointments; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
chemical_list: D009824:Ointments; D016712:Mupirocin