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Journal of Antimicrobial Chemotherapy (1993) 31, 909-917
© 1993 The British Society for Antimicrobial Chemotherapy

other

Treatment of familial staphylococcal infection—comparison of mupirocin nasal ointment and chiorhexidine/neomycin (Naseptin) cream in eradication of nasal carriage

D. A. Leigh and G. Joy

Department of Microbiology, Wycombe General Hospital, High Wycombe Bucks HP11 2TT, UK

Received 21 November 1991; accepted 11 February 1993

Twenty-six families with recurrent staphylococcal infections were treated with either mupirocin nasal ointment (group M) or chiorhexidine neomycin (Naseptin) cream (group N) to the anterior nares, each combined with chiorhexidine soap for washing and chlorhexidine powder applied to other possible carriage sites. Patients receiving mupirocin following failure with chlorhexidine/neomycin (group M/N) were also treated. Treatment was given for seven days to 99 patients, 32 index (infected) patients and 67 family members. Follow-up swabs were collected by a study nurse 8, 14, 28, and 91 days after starting treatment. The carriage of Staphylococcus aureus in the anterior nares was 67%, in the axillae 22%, in the groin 23%, and perianal 19%. The carriage rates in the index patients was higher than family members, in all sites. The eradication of S. aureus from the nasal carriage site after therapy at 8 days was 95% in group M, 85% in group M/N and 61% in group N. Recolonization during the follow-up period was much less in those treated with mupirocin: 57% of patients in group M and 42% in group M/N were not carriers at 91 days, whereas 89% of patients group N were again colonized. Assessment clinically and in terms of prevention of further infective lesions showed that there was a higher response to mupirocin than to chlorhexidine/neomycin. Mupirocin nasal is a successful therapy for removing nasal carriage of S. aureus and has a prolonged effect on recolonization.


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