The use of nasal mupirocin ointment to prevent Staphylococcus aureus bacteraemias in haemodialysis patients: an analysis of cost-effectiveness.

Nasal carriage of Staphylococcus aureus is a risk factor for the development of infections caused by S. aureus in haemodialysis patients. This study compared the incidence of bacteraemia caused by S. aureus during 6 months of use of nasal 2% calcium mupirocin ('Nasal Bactroban') 3-times a week for nasal carriers with the incidence observed previously in the same dialysis unit without the use of mupirocin. Nasal mupirocin led to the total eradication of nasal carriage of S. aureus, a 4.26-fold reduction in the incidence of S. aureus bacteraemia, and a substantial cost saving. After a cumulative experience of nasal mupirocin in haemodialysis patients of more than 43 patient-years, the development of mupirocin resistance was not observed.