TY - JOUR
T1 - Eradication of methicllin-resistant staphylococcus aureus carriage
T2 - A systematic review
AU - Ammerlaan, Heidi S.M.
AU - Kluytmans, Jan A.J.W.
AU - Wertheim, Heiman F.L.
AU - Nouwen, Jan L.
AU - Bonten, Marc J.M.
N1 - Funding Information:
Potential conflicts of interest. M.J.M.B. has received research funding from Novartis and 3M, is a member of the speakers’ bureau for Pfizer, and is a member of the advisory boards of 3M and Novartis. J.L.N. is a member of the advisory board of GlaxoSmithKline. J.A.J.W.K. has received consulting fees from 3M, Novabay, and Wyeth and has received honoraria from 3M and Becton Dickenson for lectures. H.S.M.A. and H.F.L.W.: no conflicts.
PY - 2009/4/1
Y1 - 2009/4/1
N2 - A systematic review was performed to determine the effectiveness of different approaches for eradicating methicillin-resistant Staphylococcus aureus carriage. Twenty-three clinical trials were selected that evaluated oral antibiotics (7 trials), topically applied antibiotics (12 trials), or both (4 trials). Because of clinical heterogeneity, quantitative analysis of all studies was deemed to be inappropriate, and exploratory subgroup analyses were performed for studies with similar study populations, methods, and targeted bacteria. The estimated pooled relative risk of treatment failure 1 week after short-term nasal mupirocin treatment, compared with placebo, was 0.10 (range, 0.07-0.14). There was low heterogeneity between study outcomes, and effects were similar for patients and healthy subjects, as well as in studies that included only methicillin-susceptible S. aureus carriers or both methicillin-susceptible S. aureus and methicillin-resistant S. aureus carriers. The development of drug resistance during treatment was reported in 1% and 9% of patients receiving mupirocin and oral antibiotics, respectively. Short-term nasal application of mupirocin is the most effective treatment for eradicating methicillin-resistant S. aureus carriage, with an estimated success of rate of 90% 1 week after treatment and ∼60% after a longer follow-up period.
AB - A systematic review was performed to determine the effectiveness of different approaches for eradicating methicillin-resistant Staphylococcus aureus carriage. Twenty-three clinical trials were selected that evaluated oral antibiotics (7 trials), topically applied antibiotics (12 trials), or both (4 trials). Because of clinical heterogeneity, quantitative analysis of all studies was deemed to be inappropriate, and exploratory subgroup analyses were performed for studies with similar study populations, methods, and targeted bacteria. The estimated pooled relative risk of treatment failure 1 week after short-term nasal mupirocin treatment, compared with placebo, was 0.10 (range, 0.07-0.14). There was low heterogeneity between study outcomes, and effects were similar for patients and healthy subjects, as well as in studies that included only methicillin-susceptible S. aureus carriers or both methicillin-susceptible S. aureus and methicillin-resistant S. aureus carriers. The development of drug resistance during treatment was reported in 1% and 9% of patients receiving mupirocin and oral antibiotics, respectively. Short-term nasal application of mupirocin is the most effective treatment for eradicating methicillin-resistant S. aureus carriage, with an estimated success of rate of 90% 1 week after treatment and ∼60% after a longer follow-up period.
UR - http://www.scopus.com/inward/record.url?scp=63649144097&partnerID=8YFLogxK
U2 - 10.1086/597291
DO - 10.1086/597291
M3 - Review article
C2 - 19231978
AN - SCOPUS:63649144097
SN - 1058-4838
VL - 48
SP - 922
EP - 930
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 7
ER -