A randomized clinical trial of mupirocin in the eradication of Staphylococcus aureus nasal carriage in human immunodeficiency virus disease.

Author(s): Martin JN, Perdreau-Remington F, Kartalija M, Pasi OG, Webb M, Gerberding JL, Chambers HF, Tauber MG, Lee BL

Affiliation(s): Center for AIDS Prevention Studies, AIDS Research Institute, and Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94105, USA. martin@psg.ucsf.edu

Publication date & source: 1999-09, J Infect Dis., 180(3):896-9.

Publication type: Clinical Trial; Randomized Controlled Trial

Seventy-six human immunodeficiency virus (HIV)-infected patients with Staphylococcus aureus nasal carriage were randomized to treatment groups receiving intranasal mupirocin or placebo twice daily for 5 days. Nasal cultures for S. aureus were obtained at 1, 2, 6, and 10 weeks after therapy. At 1 week, 88% of mupirocin-treated patients had negative nasal cultures compared with 8% in placebo patients (P<.001). The percentage of mupirocin-treated patients with persistently negative nasal cultures decreased over time (63%, 45%, and 29% at 2, 6, and 10 weeks, respectively) but remained significantly greater than the placebo group (3% at 2, 6, and 10 weeks). In mupirocin-treated patients, most (16/19) instances of nasal recolonization were with pretreatment strains (determined by means of by pulsed field gel electrophoresis); mupirocin resistance was not observed. Five days of treatment with mupirocin eliminated S. aureus nasal carriage in HIV-infected patients for several weeks; however, since the effect waned over time, intermittent dosing regimens should be considered for long-term eradication.