title: Mupirocin in the Treatment of Staphylococcal Infections in Chronic Rhinosinusitis: A Meta-Analysis.
abstract: BACKGROUND
  Saline irrigation of the nasal cavity is a classic and effective treatment for acute or chronic rhinosinusitis. Topical antibiotics such as mupirocin have been widely used for recalcitrant chronic rhinosinusitis. Therefore, the purpose of this study was to evaluate the effect of saline irrigation using mupirocin.
  
  
  METHODS
  A systematic literature review and meta-analysis of mupirocin saline irrigation were performed using EMBASE, MEDLINE, and Cochrane library through December 2015. Data were analyzed with R 3.2.2 software. A random effects model was used because of the diversity of included studies. Sensitivity analysis of particular tested groups and single proportion tests were also performed. The main outcome measure was residual staphylococcal infection, as confirmed by culture or PCR.
  
  
  RESULTS
  Two RCTs, two prospective studies and two retrospective studies were included. A random effects model meta-analysis of the pooled data identified a relative risk of residual infection of 0.13 (95% CI: 0.06-0.26, p<0.05) with low heterogeneity (I2 = 0%). The proportion of residual staphylococcal infections after 1 month was 0.08 (95% CI: 0.04-0.16). However, this proportion increased to 0.53 at 6 months (95% CI: 0.27-0.78).
  
  
  CONCLUSIONS
  The short-term use of mupirocin has a strongly reductive effect on staphylococcal infection in chronic rhinosinusitis. Although there is currently a lack of clear evidence, future studies with well-designed inclusion criteria and randomized controlled trials are needed to examine mupirocin's long-term effect on chronic rhinosinusitis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju, Republic of Korea.|Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.
authors.forename: Jong Seung
authors.identifier: http://orcid.org/0000-0002-1384-6799
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju, Republic of Korea.|Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.
authors.forename: Sam Hyun
authors.initials: SH
authors.lastname: Kwon
mesh_terms: D000281:Administration, Intranasal; D006801:Humans; D016712:Mupirocin / Q000627:therapeutic use*; D009296:Nasal Cavity / Q000187:drug effects / Q000382:microbiology; D055556:Nasal Lavage; D010256:Paranasal Sinuses / Q000187:drug effects / Q000382:microbiology; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012220:Rhinitis / Q000188:drug therapy* / Q000382:microbiology; D012852:Sinusitis / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity; D007507:Therapeutic Irrigation
chemical_list: D016712:Mupirocin