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Perioperative Intranasal Mupirocin for the Prevention of Surgical-Site Infections: Systematic Review of the Literature and Meta-Analysis

Published online by Cambridge University Press:  21 June 2016

Alexander J. Kallen ,
Chad T. Wilson  and
Robin J. Larson
Alexander J. Kallen*
Affiliation:
VA Outcomes Group, VA Medical Center, White River Junction, Vermont Dartmouth Medical School, Hanover, New Hampshire
Chad T. Wilson
Affiliation:
VA Outcomes Group, VA Medical Center, White River Junction, Vermont Dartmouth Medical School, Hanover, New Hampshire
Robin J. Larson
Affiliation:
VA Outcomes Group, VA Medical Center, White River Junction, Vermont Dartmouth Medical School, Hanover, New Hampshire
*
VA Outcomes Group, 215 North Main Street, VA Medical Center, White River Junction, VT 05009, Alexander.J.Kallen@dartmouth.edu
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Abstract

Objective:

To review the evidence evaluating perioperative intranasal mupirocin for the prevention of surgical-site infections according to type of surgical procedure.

Design:

Systematic review and meta-analysis of published clinical trials.

Setting:

Studies included were either randomized clinical trial or prospective trials at a single institution that measured outcomes both before and after an institution-wide intervention (before-after trial). In all studies, intervention and control groups differed only by the use of perioperative intranasal mupirocin in the intervention group.

Patients:

Patients undergoing general or nongeneral surgery (eg, cardiothoracic surgery, orthopedic surgery, and neurosurgery).

Main Outcome Measure:

Risk of surgical-site infection following perioperative intranasal mupirocin versus usual care.

Results:

Three randomized and four before-after trials met the inclusion criteria. No reduction in surgical-site infection rate was seen in randomized general surgery trials (summary estimates: 8.4% in the mupirocin group and 8.1% in the control group; relative risk [RR], 1.04; 95% confidence interval [CI95], 0.81 to 1.33). In nongeneral surgery, the use of mupirocin was associated with a reduction in surgical-site infection in randomized trials (summary estimates: 6.0% in the mupirocin group and 7.6% in the control group; RR, 0.80; CI95, 0.58 to 1.10) and in before-after trials (summary estimates: 1.7% in the mupirocin group and 4.1% in the control group; RR, 0.40; CI95, 0.29 to 0.56).

Conclusions:

Perioperative intranasal mupirocin appears to decrease the incidence of surgical-site infection when used as prophylaxis in nongeneral surgery. Given its low risk and low cost, use of perioperative intranasal mupirocin should be considered in these settings.

Type
Orginal Article
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 12 , December 2005 , pp. 916 - 922
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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