Nasal antibiotic ointment reduces infection risk after surgery

In what may be the largest clinical trial to evaluate the effectiveness of antimicrobial agents in preventing surgical wound and hospital-based infections caused by Staphylococcus aureus, scientists at the University of Iowa and Johns Hopkins found that an antibiotic ointment, called mupirocin (moo-PIE-roe-sin), smeared inside the nose cut infection rates in half or better.

"Our results carry tremendous implications for reducing S. aureus surgical wound and other hospital-based infections, and for preventing illness and saving lives," says Trish Perl, M.D., associate professor of medicine, director of Hospital Epidemiology and Infection Control at Hopkins and an author of the study published in the June 13 issue of the New England Journal of Medicine.

Staphylococcus aureus is a widely distributed germ that normally resides in the nostrils of an estimated 25 to 30 percent of all hospitalized patients without causing harm. But it can contaminate surgical sites, causing severe and often deadly infections, especially in people with weakened immune systems, and contributing millions of dollars yearly to the costs of health care.

In the study, called MARS (for Mupirocin and the Risk of Staphyloccus aureus Infections), the researchers determined the rate of S. aureus surgical wound infections and other hospital-based infections in 4,030 adult patients who underwent various elective surgical procedures at the University of Iowa Hospitals and Clinics and the Veteran's Affairs Medical Center in Iowa City. Mupirocin antibiotic ointment, or a placebo, was applied to the inside of the nostrils twice daily for up to five days before surgery. Patients were followed for 30 days after surgery to determine if they acquired S. aureus infections.

While mupirocin ointment, made by GlaxoSmithKline, is highly effective at reducing the rate of S. aureus infections in patients undergoing surgery, as with any antibiotic, there is the risk of widespread r

Contact: Trent Stockton
Johns Hopkins Medical Institutions

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