Effect of rifampin and bacitracin on nasal carriers of Staphylococcus aureus

Abstract

Anterior nares cultures from 664 hospital personnel identified 165 (24.8%) as carriers of Staphylococcus aureus. Persistent carriers (17.8%) were identified and randomly assigned to one of four treatment groups: rifampin (600 mg once a day for 5 days), bacitracin ointment (topically applied three times a day for 10 days), combined rifampin and bacitracin, and control (no treatment). Bacitracin ointment was ineffective in eliminating S. aureus from the anterior nares and had a postreatment carrier rate equal to the control rate. Rifampin therapy caused a highly significant reduction (79%) in carriage; however, combined therapy was not as effective as treatment with rifampin alone. Of 132 strains of staphylococci isolated before and after treatment, all were susceptible to less than 0.016 micrograms of rifampin per ml. This study demonstrates that rifampin may be an effective antistaphylococcal antibiotic and could be used to control the carrier state in high-risk situations.

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

“…Neben Mupirocin wurden Bacitracin, Fusidinsäure oder Neomycin als topische Antibiotika zur nasalen Therapie eingesetzt [375][376][377][378][379]. Diese Antibiotika waren jedoch zum Teil nicht besser als das Placebo [376] oder wurden nur wenig untersucht [375,377].…”

“…Diese Antibiotika waren jedoch zum Teil nicht besser als das Placebo [376] oder wurden nur wenig untersucht [375,377].…”

Staphylococcus aureus nasal carriage during the infectious diseases national congress in France

“…The rate of resistance is proportional to its use: from 1% of MRSA having acquired resistance to mupirocine after 5 days of decolonization up to 60% of resistant MRSA on areas treated several (wounds, nose, etc.) [32]. The authors of an American study assessed the cost-effectiveness of screening for nasal carriage every 3 months associated to a systematic treatment of all SA nasal carriers in hemodialyzed patients.…”

Factors Affecting Staphylococcal Colonization Among NIDDM Outpatients

“…Studies have convincingly shown that colonization with S. aureus usually precedes infection (8,9) and that it can often be eradicated (10,11). In view of recent evidence in hemodialysis patients that control of S. aureus colonization can reduce the incidence of staphylococcal infections (10), it is important to detemine the factors predisposing to staphylococcal colonization in diabetic patients.…”