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Randomized Controlled Trial
. 2010 Dec;55(4):466-72.
doi: 10.1097/QAI.0b013e3181ec2a68.

The NOSE study (nasal ointment for Staphylococcus aureus eradication): a randomized controlled trial of monthly mupirocin in HIV-infected individuals

Rachel J Gordon  1 , Nancy Chez, Haomiao Jia, Barbara Zeller, Magda Sobieszczyk, Caitlin Brennan, Katherine B Hisert, Mei-Ho Lee, Peter Vavagiakis, Franklin D Lowy
Affiliations
Randomized Controlled Trial

The NOSE study (nasal ointment for Staphylococcus aureus eradication): a randomized controlled trial of monthly mupirocin in HIV-infected individuals

Rachel J Gordon et al. J Acquir Immune Defic Syndr. 2010 Dec.

Abstract

Background: HIV-positive patients at HELP/PSI, Inc, an in-patient drug rehabilitation center, had a high baseline prevalence of Staphylococcus aureus colonization (49%) and incidence of infection (17%) in a previous year-long study.

Methods: A randomized, double-blinded, placebo-controlled study was conducted to determine whether repeated nasal application of mupirocin ointment would decrease the odds of S. aureus nasal colonization in 100 HELP/PSI patients over an 8-month period. A 5-day course of study drug was given monthly, and colonization was assessed at baseline and 1 month after each treatment. S. aureus infection was a secondary outcome.

Results: In repeated-measures analysis, mupirocin reduced the odds of monthly S. aureus nasal colonization by 83% compared with placebo [adjusted odds ratio (ORadj) = 0.17; P < 0.0001]. Subjects colonized at study entry had a 91% reduction in subsequent colonization (ORadj = 0.09; P < 0.0001). Mupirocin also suppressed S. aureus colonization in subjects not colonized at baseline (ORadj = 0.23; P = 0.006). There was no difference in infection rates between the mupirocin and placebo groups (hazard ratio = 0.49, P = 0.29).

Conclusions: Monthly application of nasal mupirocin significantly decreased S. aureus colonization in HIV patients in residential drug rehabilitation. Monthly mupirocin application has a potential role in long-term care settings or in HIV-positive patients with high rates of S. aureus colonization and infection.

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Conflict of interest statement

Conflicts of Interest

None of the authors report any conflicts of interest.

Figures

Figure 1
Figure 1. Patient Screening, Exclusions, Randomization and Follow-up
Figure 1 describes the flow of people through the study from screening through follow-up. *For two subjects, it was unclear whether they first left the study site or withdrew from the study.
Figure 2
Figure 2. Effect of mupirocin on S. aureus nasal colonization
Figure 2 shows the percentage of the mupirocin and placebo groups nasally colonized with S. aureus at baseline and at each month of the subjects’ follow-up. The number of subjects cultured at each follow-up month is shown.
See this image and copyright information in PMC

References

    1. Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998 Aug 20;339(8):520–532. - PubMed
    1. Wertheim HF, Melles DC, Vos MC, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis. 2005 Dec;5(12):751– 762. - PubMed
    1. Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997;10(3):505–520. - PMC - PubMed
    1. Nguyen MH, Kauffman CA, Goodman RP, et al. Nasal carriage of and infection with Staphylococcus aureus in HIV-infected patients. Ann Intern Med. 1999 Feb 2;130(3):221–225. - PubMed
    1. Miller M, Cespedes C, Vavagiakis P, Klein RS, Lowy FD. Staphylococcus aureus colonization in a community sample of HIV-infected and HIV-uninfected drug users. Eur J Clin Microbiol Infect Dis. 2003 Aug;22(8):463–469. - PubMed

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