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Antimicrob Agents Chemother. 1989 August; 33(8): 1358-1361

Efficacy of mupirocin in methicillin-resistant Staphylococcus aureus burn wound infection.

H Rode, D Hanslo, P M de Wet, A J Millar and S Cywes

Department of Paediatric Surgery, University of Cape Town, Rondebosch, South Africa.

ABSTRACT

Methicillin-resistant Staphylococcus aureus strains (MRSA) have become increasingly prevalent as nosocomial pathogens, especially in burn wounds. MRSA constituted 38% of all S. aureus isolates in our 25-bed burns unit despite the utilization of a combination of 1% silver sulfadiazine and 0.2% chlorhexidine as topical therapy. Mupirocin, a new antibiotic, has proved in vitro and in vivo to be highly effective in the treatment of MRSA infections. A prospective clinical trial with mupirocin ointment in MRSA burn wound infection was untertaken. Forty-five children with 59 discrete burn wounds and from whom MRSA were isolated were treated with 2% mupirocin ointment under occlusive dressings, applied twice daily for 5 days. The average burned area treated was 8% (range, 2 to 20%) of the total body surface area. The burn wounds were assessed clinically and bacteriologically daily. Mupirocin eliminated MRSA in all 59 wounds treated, with the maximum therapeutic response seen within 4 days. In three wounds, gram-negative organisms persisted after 5 days of topical therapy. Treatment was well tolerated by all children. We recommend that mupirocin in its present polyethylene glycol base should be used only on a selective basis, when current prophylactic topical therapy has failed to control MRSA infection in burns of less than 20% of the total body surface area, and that it should be applied only for a limited period of 5 days. The safety and the efficacy of mupirocin in burns exceeding 20% of the total body surface area need to be established.

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Antimicrob Agents Chemother. 1989 August; 33(8): 1358-1361

This article has been cited by other articles:

• Church, D., Elsayed, S., Reid, O., Winston, B., Lindsay, R. (2006). Burn Wound Infections. Clin. Microbiol. Rev. 19: 403-434 [Abstract] [Full Text]