Title : Preoperative nasal decolonization using mupirocin vs neomycin vs placebo intranasal ointment and its effect on surgical site infection among cardiac surgery patients: A randomized controlled trial
Abstract:
Objective: To evaluate the effectiveness of 2% Mupirocin vs 0.5% Neomycin vs placebo intranasal ointment on prevention of surgical site infections (SSIs) among adult patients undergoing cardiac surgery at AIIMS, New Delhi.
Materials and methods: In this randomized, double-blinded, placebo-controlled multi-arm trial, 180 adult patients undergoing cardiac surgery received preoperative nasal decolonization using 2% mupirocin or 0.5 % neomycin in experiment group 1 and 2, or 0.9% NS (Normal Saline) as placebo intervention in the control group, at the time of admission to the hospital and two hours before the surgery to prevent surgical site infection. The effectiveness of the type of intervention was compared using Southampton Scoring system on 2nd,8th ,14th, and 30 days after surgery and the association of the demographic and clinical profile data with surgical site infection was calculated.
Results: The study found that 2% Mupirocin was more effective in reducing the incidence and severity of SSI compared to placebo intranasal application at p=0.008. No significant difference was found in the effectiveness of 0.5% Neomycin vs placebo intranasal ointment (at p=0.270) and in 2% Mupirocin vs 0.5% Neomycin in preventing SSI at p=0.138. The incidence of SSI was reported to be higher in the control group (45.45%) than in the Neomycin group (27.27%) and the least was reported in the Mupirocin group (15.78%). Demographic factors like age, gender, and clinical co-morbidities like hypertension, diabetes, hyperlipidaemia, and type of surgery were associated with SSI.
Conclusion: Preoperative nasal decolonization using 2% Mupirocin intranasal ointment was effective in reducing the incidence and severity of SSIs among adult patients undergoing cardiac surgery.
