The usefulness of nasal mupirocin in preventing recurrent staphylococcal nasal colonization and
skin infection has been examined in immunodeficient patients and in healthy staphylococcal carriers but not in immunocompetent staphylococcal carriers who experience
recurrent skin infections. We studied 34 such patients.
After an initial 5-day course of nasal mupirocin ointment for all patients, 17 patients continued to apply a 5-day course of nasal mupirocin every month for 1
year, and the other 17 patients applied a placebo ointment. Nasal cultures were obtained monthly, and all episodes of skin infection were recorded.
The overall number of positive nasal cultures
was 22 in the mupirocin group and 83 in the placebo
group (P<.001), and the number of skin infections was
26 and 62, respectively (P<.002). Eight of the 17 mupirocin-treated patients but only 2 in the placebo group remained free of positive staphylococcal nasal cultures. One
of the 10 patients who were free of colonization during
the 12-month treatment period had skin infections, in
contrast to all 24 of the patients with positive cultures
(P<.01). Staphylococci resistant to mupirocin were observed in 1 patient. No adverse effects were reported.
A monthly application of mupirocin ointment in staphylococcal carriers reduces the incidence of
nasal colonization, which in turn lowers the risk of skin
infection.(Arch Intern Med. 1996;156:1109-1112)