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Eradication of methicillin-resistant Staphylococcus aureus (MRSA) throat carriage : A randomised trial comparing topical treatment with rifampicin-based systemic therapy

Lindgren, Anna Karin LU ; Nilsson, Anna C. LU ; Åkesson, Per LU ; Gustafsson, Eva and Melander, Eva LU (2018) In International Journal of Antimicrobial Agents 51(4). p.642-645
Abstract

Eradication of methicillin-resistant Staphylococcus aureus (MRSA) colonisation may prevent transmission of strains between patients and reduces the risk of clinical infection. Colonisation of the throat is associated with prolonged carriage and is more difficult to eradicate. An open randomised study was conducted to evaluate two eradication protocols. Patients with pharyngeal carriage of MRSA were enrolled at six Swedish centres during 4 years. One treatment group received oral rifampicin and either clindamycin or trimethoprim/sulfamethoxazole (SXT) for 7 days in combination with nasal mupirocin. Patients in the other group were treated with nasal mupirocin only. Patients in the same household were randomised together. Both groups... (More)

Eradication of methicillin-resistant Staphylococcus aureus (MRSA) colonisation may prevent transmission of strains between patients and reduces the risk of clinical infection. Colonisation of the throat is associated with prolonged carriage and is more difficult to eradicate. An open randomised study was conducted to evaluate two eradication protocols. Patients with pharyngeal carriage of MRSA were enrolled at six Swedish centres during 4 years. One treatment group received oral rifampicin and either clindamycin or trimethoprim/sulfamethoxazole (SXT) for 7 days in combination with nasal mupirocin. Patients in the other group were treated with nasal mupirocin only. Patients in the same household were randomised together. Both groups followed a hygiene protocol including chlorhexidine washing. Cultures from the nares, perineum and throat were taken at baseline and then at 2 weeks, 2 months and 6 months after the end of treatment. A total of 28 patients received rifampicin-based systemic antibiotics and 24 subjects received mupirocin only. At follow-up 6 months after the end of treatment, 61% of patients and 50% of households in the systemic antibiotics group had culture results negative for MRSA. Significantly less patients (12%) and households (10%) became decolonised in the group receiving topical treatment only. A combination of rifampicin and either clindamycin or SXT was more effective in eliminating pharyngeal MRSA carriage compared with topical treatment with mupirocin only.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Eradication, MRSA, Throat carriage
in
International Journal of Antimicrobial Agents
volume
51
issue
4
pages
642 - 645
publisher
Elsevier
external identifiers
  • pmid:28843819
  • pmid:28843819
  • scopus:85042946819
ISSN
0924-8579
DOI
10.1016/j.ijantimicag.2017.08.021
language
English
LU publication?
yes
id
d1157fbf-d91d-4b47-be4d-a1b0f351ec3b
date added to LUP
2018-03-27 09:06:45
date last changed
2020-04-07 04:46:35
@article{d1157fbf-d91d-4b47-be4d-a1b0f351ec3b,
  abstract     = {<p>Eradication of methicillin-resistant Staphylococcus aureus (MRSA) colonisation may prevent transmission of strains between patients and reduces the risk of clinical infection. Colonisation of the throat is associated with prolonged carriage and is more difficult to eradicate. An open randomised study was conducted to evaluate two eradication protocols. Patients with pharyngeal carriage of MRSA were enrolled at six Swedish centres during 4 years. One treatment group received oral rifampicin and either clindamycin or trimethoprim/sulfamethoxazole (SXT) for 7 days in combination with nasal mupirocin. Patients in the other group were treated with nasal mupirocin only. Patients in the same household were randomised together. Both groups followed a hygiene protocol including chlorhexidine washing. Cultures from the nares, perineum and throat were taken at baseline and then at 2 weeks, 2 months and 6 months after the end of treatment. A total of 28 patients received rifampicin-based systemic antibiotics and 24 subjects received mupirocin only. At follow-up 6 months after the end of treatment, 61% of patients and 50% of households in the systemic antibiotics group had culture results negative for MRSA. Significantly less patients (12%) and households (10%) became decolonised in the group receiving topical treatment only. A combination of rifampicin and either clindamycin or SXT was more effective in eliminating pharyngeal MRSA carriage compared with topical treatment with mupirocin only.</p>},
  author       = {Lindgren, Anna Karin and Nilsson, Anna C. and Åkesson, Per and Gustafsson, Eva and Melander, Eva},
  issn         = {0924-8579},
  language     = {eng},
  number       = {4},
  pages        = {642--645},
  publisher    = {Elsevier},
  series       = {International Journal of Antimicrobial Agents},
  title        = {Eradication of methicillin-resistant Staphylococcus aureus (MRSA) throat carriage : A randomised trial comparing topical treatment with rifampicin-based systemic therapy},
  url          = {http://dx.doi.org/10.1016/j.ijantimicag.2017.08.021},
  doi          = {10.1016/j.ijantimicag.2017.08.021},
  volume       = {51},
  year         = {2018},
}