Mehtar S
South Cape/Karoo Provincial Administration, Western Cape, Republic of South Africa.
J Hosp Infect. 1998 Sep;40 Suppl B:S39-44. doi: 10.1016/s0195-6701(98)90203-1.
Nasal mupirocin has an important role to play in the prevention of Staphylococcus aureus infection by eliminating nasal carriage of this organism. Indeed, in many countries nasal mupirocin is one of the mainstays for controlling outbreaks of methicillin-resistant S. aureus. Eradication of nasal S. aureus with mupirocin has been shown to be effective in preventing postoperative infections in patients undergoing cardiothoracic surgery and in preventing exit-site infections in patients undergoing haemodialysis. It has been proposed that the use of mupirocin should be extended to other situations, such as the prevention of postoperative infections in patients undergoing implant surgery and the prevention of bacteraemias in high-risk patients. Clinical trials are needed to establish the efficacy of mupirocin in these situations. Both low-level and high-level resistance have been reported during treatment with nasal mupirocin. Low-level resistance does not represent a significant clinical problem but high-level resistance resulting from indiscriminate use may give grounds for concern. Further review of these issues is required. As with any antibiotic, mupirocin should be used judiciously, as part of an integrated programme of infection control.
鼻用莫匹罗星通过消除鼻腔中金黄色葡萄球菌的定植，在预防金黄色葡萄球菌感染方面发挥着重要作用。事实上，在许多国家，鼻用莫匹罗星是控制耐甲氧西林金黄色葡萄球菌暴发的主要手段之一。已证明用莫匹罗星根除鼻腔中的金黄色葡萄球菌可有效预防心胸外科手术患者的术后感染以及血液透析患者的导管出口部位感染。有人提议将莫匹罗星的使用扩展到其他情况，如预防植入手术患者的术后感染以及预防高危患者的菌血症。需要进行临床试验来确定莫匹罗星在这些情况下的疗效。在用鼻用莫匹罗星治疗期间，已报告了低水平和高水平耐药情况。低水平耐药并不代表严重的临床问题，但因滥用导致的高水平耐药可能令人担忧。需要对这些问题进行进一步审查。与任何抗生素一样，莫匹罗星应谨慎使用，作为感染控制综合计划的一部分。
