title: A randomized clinical trial of mupirocin in the eradication of Staphylococcus aureus nasal carriage in human immunodeficiency virus disease.
abstract: Seventy-six human immunodeficiency virus (HIV)-infected patients with Staphylococcus aureus nasal carriage were randomized to treatment groups receiving intranasal mupirocin or placebo twice daily for 5 days. Nasal cultures for S. aureus were obtained at 1, 2, 6, and 10 weeks after therapy. At 1 week, 88% of mupirocin-treated patients had negative nasal cultures compared with 8% in placebo patients (P<.001). The percentage of mupirocin-treated patients with persistently negative nasal cultures decreased over time (63%, 45%, and 29% at 2, 6, and 10 weeks, respectively) but remained significantly greater than the placebo group (3% at 2, 6, and 10 weeks). In mupirocin-treated patients, most (16/19) instances of nasal recolonization were with pretreatment strains (determined by means of by pulsed field gel electrophoresis); mupirocin resistance was not observed. Five days of treatment with mupirocin eliminated S. aureus nasal carriage in HIV-infected patients for several weeks; however, since the effect waned over time, intermittent dosing regimens should be considered for long-term eradication.
authors.affiliation: Center for AIDS Prevention Studies, AIDS Research Institute, and Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94105, USA. martin@psg.ucsf.edu
authors.forename: J N
authors.initials: JN
authors.lastname: Martin
authors.forename: F
authors.initials: F
authors.lastname: Perdreau-Remington
authors.forename: M
authors.initials: M
authors.lastname: Kartalija
authors.forename: O G
authors.initials: OG
authors.lastname: Pasi
authors.forename: M
authors.initials: M
authors.lastname: Webb
authors.forename: J L
authors.initials: JL
authors.lastname: Gerberding
authors.forename: H F
authors.initials: HF
authors.lastname: Chambers
authors.forename: M G
authors.initials: MG
authors.lastname: Täuber
authors.forename: B L
authors.initials: BL
authors.lastname: Lee
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission; D000281:Administration, Intranasal; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D016712:Mupirocin / Q000627:therapeutic use*; D017817:Nasal Lavage Fluid / Q000382:microbiology*; D009824:Ointments; D010919:Placebos; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission; D013211:Staphylococcus aureus / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D009824:Ointments; D010919:Placebos; D016712:Mupirocin