Surgical Site Infections in Orthopedic Surgery: The Effect of Mupirocin Nasal Ointment in a Double‐Blind, Randomized, Placebo‐Controlled Study

TLDR

The study aimed to assess whether perioperative mupirocin nasal ointment eradicates Staphylococcus aureus carriage and reduces surgical site infections in orthopedic surgery. In a randomized, double‑blind, placebo‑controlled trial, 614 patients received mupirocin or placebo ointment twice daily from admission until surgery, with 315 assigned to mupirocin and 299 to placebo. Mupirocin markedly eradicated nasal carriage (83.5% vs 27.8%) and lowered endogenous S.

Abstract

The objective of this study was to determine whether use of mupirocin nasal ointment for perioperative eradication of Staphylococcus aureus nasal carriage is effective in preventing the development of surgical site infections (SSIs). A randomized, double-blind, placebo-controlled design was used. Either mupirocin or placebo nasal ointment was applied twice daily to 614 assessable patients from the day of admission to the hospital until the day of surgery. A total of 315 and 299 patients were randomized to receive mupirocin and placebo, respectively. Eradication of nasal carriage was significantly more effective in the mupirocin group (eradication rate, 83.5% versus 27.8%). In the mupirocin group, the rate of endogenous S. aureus infections was 5 times lower than in the placebo group (0.3% and 1.7%, respectively; relative risk, 0.19; 95% confidence interval, 0.02–1.62). Mupirocin nasal ointment did not reduce the SSI rate (by S. aureus) or the duration of hospital stay