February 1992

Mupirocin Treatment of Nasal Staphylococcal Colonization

Author Affiliations

From the Departments of Medicine (Drs Scully, Briones, Gu, and Neu) and Pharmacology (Dr Neu), College of Physicians and Surgeons, Columbia University, New York, NY 10032 (Dr Scully).

Arch Intern Med. 1992;152(2):353-356. doi:10.1001/archinte.1992.00400140099022

The effectiveness and safety of mupirocin calcium ointment applied to the anterior part of the nares for 5 days in the eradication of nasal carriage of Staphylococcus aureus was investigated in a placebo-controlled, double-blind study. Subjects were healthy medical center staff who had two positive cultures of the anterior nares for S aureus. Antimicrobial susceptibility, phage typing, and restriction endonuclease analysis of plasmid DNA were used to monitor the identity of relapsing and persisting strains. Mupirocin eliminated 74% of S aureus at early follow-up and 91% of original strains. At 4 weeks, 78% of the original strains were eradicated, whereas all of the placebo group remained colonized. Recolonization with mupirocin-resistant strains occurred in six patients, but these were of different phage and plasmid types from the original isolates. None of the subjects had serious adverse effects. Applied intranasally for 5 days, a calcium preparation of mupirocin in a paraffin base is effective in eliminating S aureus nasal carriage and is well tolerated.

(Arch Intern Med. 1992;152:353-356)