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General Surgery

Answer 5
  1. Mupirocin reduces the risk for S. aureus surgical site infection is reduced. S. aureus causes 25% of nosocomial infections and contributes substantially to complications and costs of hospitalization. S. aureus reside in the interior nares, and 25% to 30% of the population carries this organism at a given time. A large, randomized, double-blinded, placebo-controlled trial to determine whether intranasal treatment with mupirocin ointment reduces the rate of S. aureus infections at surgical sites and prevents other nosocomial infections showed no difference in the rate of surgical site infections between the placebo and mupirocin group (2.4% versus 2.3%; P > 0.05) and showed a decrease in overall nosocomial S. aureus infection rate (7.7% versus 4.0%; P = 0.02). Results of pulsed-field gel electrophoresis suggested that some patients may have been infected with strains transmitted from health care workers or other patients; perioperative mupirocin could not prevent infections that originated in this manner. One concern raised by investigators was that using mupirocin might lead to widespread resistance, but a single short course of mupirocin should not affect resistance.6

    6. Perl TM, Cullen JJ, Wenzel RP, et al. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. Mupirocin and the Risk of Staphylococcus aureus Study Team. N Engl J Med 2002;346:1871-7.

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