Table 4.
Intranasal mupirocin Staphylococcus decolonization protocols used for the prevention of blood stream infections in the hemodialysis setting
| Study | N | Methods | Standard Definition of Bloodstream Infection Used | Definition of Bloodstream Infection | Protocol | Treatment Group | Outcome | Staphylococcus aureus Infection Rate/Patient yr | P Value | Concerns |
|---|---|---|---|---|---|---|---|---|---|---|
| Kang et al. (95) | 19 | Open, prospective cohort study | No | Not reported | Mupirocin twice per d for 5 d for 6 mo | MRSA nasal carriers | Bloodstream infection | 1 Bloodstream infection | N/A | Potential for resistance |
| Lederer et al. (96) | 16 | Open, prospective cohort study | No | Not reported | Mupirocin three times per d for 5 d for 12 mo | MRSA nasal carriers | Bloodstream infection | 0 | N/A | Potential for resistance |
| Kluytmans et al. (97) | 226 | Open, prospective cohort study compared with historical controls | No | Not reported | Mupirocin twice per d for 5 d, then weekly for 6 mo | Staphylococcus aureus nasal carriers | Bloodstream infection | 0.25 versus 0.04 | <0.001 | No resistance observed |
| Boelaert et al. (98) | 80 | Open, prospective cohort study compared with historical controls | No | Positive blood cultures (two out of six bottles) | Mupirocin three times per d for 5 d, then three times per wk for 6 mo, then weekly for 18 mo | Staphylococcus aureus nasal carriers | Bloodstream infection | 0.097 versus 0.024 | 0.008 | One mupirocin-resistant organism identified |
| Boelaert et al. (99) | 35 | Single-center, randomized, double-blind, placebo-controlled trial | No | Not reported | Mupirocin versus placebo three times per d for 14 d, then three times per wk for 9 mo | All Staphylococcus aureus nasal carriers | Bloodstream infection | 0.489 versus 0.115; 1 bloodstream infection in mupirocin-treated group | <0.05 | No resistance observed |
MRSA, Methicillin resistant Staphylococcus aureus; N/A, not available.