A randomized clinical trial of mupirocin in the eradication of Staphylococcus aureus nasal carriage in human immunodeficiency virus disease.
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.
Martin
J N
JN
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
Perdreau-Remington
F
F
Kartalija
M
M
Pasi
O G
OG
Webb
M
M
Gerberding
J L
JL
Chambers
H F
HF
Täuber
M G
MG
Lee
B L
BL
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*
D000900:Anti-Bacterial Agents; D009824:Ointments; D010919:Placebos; D016712:Mupirocin