Abstract
The effect of the prophylactic use of intranasal mupirocin ointment on the incidence of exit site infection in peritoneal dialysis patients was prospectively evaluated. Staphylococci were observed in the nares of 21 patients and this group was treated with 2% mupirocin nasal ointment three times a day for 7 days every other month for a year. Staphylococcal exit site infection rate was 0.57/patient/year with mupirocin treatment, which was significantly lower than that for the previous 1 year (1.10/patient/year, p<0.01). However, mupirocin therapy could completely eradicate Staphylococci from the nares in only 13 (responder) of 21 patients. Compliance with treatment was evaluated monthly, revealing that 8 patients had not applied the ointment to the nares more than 70% of the prescribed times. During the 1-year treatment, exit site infection occured only one time in 13 responders, while it occured 11 times in 5 of 8 patients with poor compliance (p<0.01).
In conclusion, prophylactic therapy using intranasal mupirocin was effective on lowering the incidence of exit site infection. However, periodic examination of compliance and recolonization after treatment is essential to obtain solid evidence.
