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A double-blind, randomized, controlled trial of topical polysporin triple compound versus topical mupirocin for the eradication of colonization with methicillin-resistant Staphylococcus aureus in a complex continuing care population.
Canadian Journal of Infectious Diseases and Medical Microbiology ( IF 2.6 ) Pub Date : 2009 , DOI: 10.1155/2009/274896
S O'Grady 1 , Z Hirji , B Pejcic-Karapetrovic , S Fung , H Dedier , J Takata-Shewchuk , K Zhang , J Conly
Affiliation  

BACKGROUND: Intranasal mupirocin or Polysporin Triple (PT) ointment (polymyxin B, bacitracin, gramicidin), in combination with chlorhexidine body washes, have been used for eradicating methicillin-resistant Staphylococcus aureus (MRSA), but no comparative studies have been done.METHODS: A double-blind, randomized, controlled clinical trial to compare the efficacy of mupirocin versus PT ointment in combination with chlorhexidine body washes in eradicating MRSA carriage was conducted. Asymptomatic MRSA carriers, medically stable and at least 18 years of age who were patients on medical wards, received twice daily application of either mupirocin or PT ointment to the anterior nares plus once daily 2% chlorhexidine body washes for seven days. Follow-up swabs from multiple sites using broth enrichment were conducted at 48 h, and one, two, four, eight and 12 weeks.RESULTS: Of 103 patients eligible for analysis (54 mupirocin; 49 PT), no significant differences between the two groups with respect to baseline demographics, risk factors for MRSA or MRSA colonization sites were noted. At 48 h, 35 of 54 (65%) patients in the mupirocin group versus 15 of 49 (31%) in the PT group (P=0.001) were found to be MRSA negative at all sites. Significant differences were observed at one and two weeks but were not maintained at other intervals. In those with complete microbiological follow-up, MRSA eradication at all sites occurred in 12 of 39 (30.8%) mupirocin- and one of 36 (2.8%) PT-treated patients (P=0.001).CONCLUSION: Both agents demonstrated poor efficacy and PT was significantly less efficacious than mupirocin at 12 weeks in eradicating MRSA from all sites.

中文翻译:

外用多孢菌素三联化合物与外用莫匹罗星在复杂的持续护理人群中根除耐甲氧西林金黄色葡萄球菌定植的双盲、随机、对照试验。

背景:鼻内莫匹罗星或 Polysporin Triple (PT) 软膏(多粘菌素 B、杆菌肽、短杆菌肽)与洗必泰沐浴露联合使用,已被用于根除耐甲氧西林金黄色葡萄球菌(MRSA),但尚未进行比较研究。方法:进行了一项双盲、随机、对照临床试验,以比较莫匹罗星与 PT 软膏联合洗必泰沐浴露在根除 MRSA 携带方面的疗效。无症状的 MRSA 携带者、医学上稳定且至少 18 岁且是内科病房的患者,每天两次在前鼻孔涂抹莫匹罗星或 PT 软膏,外加每天一次 2% 氯己定沐浴露,持续 7 天。在 48 小时和 1、2、4、8 和 12 周进行了使用肉汤富集的多个部位的后续拭子检查。 结果:在 103 名符合分析条件的患者中(54 名莫匹罗星;49 名 PT),两者之间没有显着差异与基线人口统计相关的群体,注意到 MRSA 或 MRSA 定植位点的危险因素。在 48 小时后,莫匹罗星组 54 名患者中的 35 名 (65%) 与 PT 组 49 名患者中的 15 名 (31%) (P = 0.001) 在所有部位均为 MRSA 阴性。在第 1 周和第 2 周观察到显着差异,但在其他时间间隔没有保持。在完全微生物学随访的患者中,39 名 (30.8%) 莫匹罗星和 36 名 (2.8%) PT 治疗患者中有 12 名发生 MRSA 根除 (P=0.001)。结论:两种药物均表现出较差的疗效在 12 周时 PT 从所有部位根除 MRSA 的效果明显低于莫匹罗星。在第 1 周和第 2 周观察到显着差异,但在其他时间间隔没有保持。在完全微生物学随访的患者中,39 名 (30.8%) 莫匹罗星和 36 名 (2.8%) PT 治疗患者中有 12 名发生 MRSA 根除 (P=0.001)。结论:两种药物均表现出较差的疗效在 12 周时 PT 从所有部位根除 MRSA 的效果明显低于莫匹罗星。在第 1 周和第 2 周观察到显着差异,但在其他时间间隔没有保持。在完全微生物学随访的患者中,39 名 (30.8%) 莫匹罗星和 36 名 (2.8%) PT 治疗患者中有 12 名发生 MRSA 根除 (P=0.001)。结论:两种药物均表现出较差的疗效在 12 周时 PT 从所有部位根除 MRSA 的效果明显低于莫匹罗星。
更新日期:2020-09-25
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