Eradication of methicillin-resistant Staphylococcus aureus (MRSA) throat carriage: a randomised trial comparing topical treatment with rifampicin-based systemic therapy
- Resource Type
- Authors
- Anna Karin Lindgren; Anna Nilsson; Eva Melander; Per Åkesson; Eva Gustafsson
- Source
- International Journal of Antimicrobial Agents. 51:642-645
- Subject
- Methicillin-Resistant Staphylococcus aureus
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Administration, Topical
030106 microbiology
Administration, Oral
Sulfamethizole
Mupirocin
medicine.disease_cause
Trimethoprim
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Throat
Internal medicine
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
business.industry
Clindamycin
Sulfamethoxazole
Chlorhexidine
General Medicine
Methicillin-resistant Staphylococcus aureus
Drug Combinations
Infectious Diseases
medicine.anatomical_structure
Carriage
chemistry
Staphylococcal Skin Infections
Rifampin
business
Rifampicin
medicine.drug
- Language
- ISSN
- 0924-8579
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.