Comparison of topical mupirocin and gentamicin in the prevention of peritoneal dialysis-related infections: A systematic review and meta-analysis.
BACKGROUND
Topical antibiotics have been shown to reduce exit-site infection and peritonitis. The aim of this study was to compare infection rates between mupirocin and gentamicin.


METHODS
Multiple comprehensive databases were searched systematically to include relevant randomized controlled trials and observational studies. Pooled risk ratios (RRs) and 95% confidence intervals were calculated for the incidences of exit-site infection and peritonitis.


RESULTS
Seven studies (mupirocin group n = 458, gentamicin group n = 448) were analyzed for exit-site infection. The risk of gram-positive exit-site infection was similar between the groups. Gram-negative exit-site infection rate was higher in the mupirocin group (RR = 2.125, P = 0.037). Six studies were assessed the peritonitis risk. There was no difference in the gram-positive and -negative peritonitis rate.


CONCLUSIONS
Topical use of gentamicin is associated with fewer exit-site infections caused by gram-negative organisms. Gentamicin has comparable efficacy to mupirocin for peritonitis and gram-positive exit-site infection.
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan.
Chia-Chi
CC
Tsai
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan.
Po-Sheng
PS
Yang
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan.
Chien-Liang
CL
Liu
Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan.
Chih-Jen
CJ
Wu
Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City, Taiwan; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
Yi-Chiung
YC
Hsu
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan. Electronic address: surg.mmh@gmail.com.
Shih-Ping
SP
Cheng
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D005839:Gentamicins / Q000627:therapeutic use*; D016905:Gram-Negative Bacterial Infections / Q000209:etiology / Q000517:prevention & control; D016908:Gram-Positive Bacterial Infections / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015233:Models, Statistical; D016712:Mupirocin / Q000627:therapeutic use*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000517:prevention & control*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D016712:Mupirocin
Exit-site infection; Gentamicin; Mupirocin; Peritoneal dialysis; Peritonitis