[Endonasal mupirocin in the prevention of nosocomial pneumonia].
BACKGROUND
To evaluate efficacy of mupirocin ointment nasal application in prevention of MRSA ventilatory associated pneumonia (VAP).


METHODS



METHODS
prospective, double-blind, randomized, clinical trial.


METHODS
48 consecutive intubated patients admitted in the Intensive Care Unit during a three month period.


METHODS
University of Florence; Intensive Care.


METHODS
Randomized application of 2 ml of Mupirocin ointment three times a day for three days (Group A; n = 24) or placebo (Group B n = 24).


METHODS
Chi 2 or Fisher exact test.


METHODS
Bacteriologic evaluation of nasal carriage at admission in ICU, and after 3 days of prevention; evaluation of bacteriology of bronchial aspirate in the case of symptoms of ventilatory associated pneumonia.


CONCLUSIONS
Relative risk of nasal carriage by pathological bacterial strains is 7.2 times in hospitalized patients more than in home patients (18/25 vs 7/23); MRSA nasal carriage is present at admission on 20% of hospitalized patients. Nasal carriage of Staphylococcus strains is reduced of 90% by Mupirocin application but is reduced only of 50% by placebo application (p < 0.05). In Group B, VAP occurred in 5 patients vs 3 of Group A; the more frequent incidence of VAP in group B is due to MRSA infection (p < 0.01) and it is related to MRSA nasal carriage.
Di Filippo
A
A
Istituto di Anestesiologia e Rianimazione, Università degli Studi, Firenze.
Simonetti
T
T
D000281:Administration, Intranasal; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003428:Cross Infection / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000008:administration & dosage / Q000627:therapeutic use*; D009824:Ointments; D018410:Pneumonia, Bacterial / Q000517:prevention & control*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D009824:Ointments; D016712:Mupirocin