Treatment of chronic rhinosinusitis exacerbations due to methicillin-resistant Staphylococcus aureus with mupirocin irrigations

American Journal of Otolaryngology
C Arturo SolaresMartin J Citardi

Abstract

Chronic rhinosinusitis (CRS) exacerbations due to methicillin-resistant Staphylococcus aureus (MRSA) are routinely encountered. Treatment often involves intravenous antibiotics that provide only transient benefits. Mupirocin has well-recognized antistaphylococcal activity, and its nasal formulation is approved by the Food and Drug Administration for the eradication of nasal colonization with MRSA. The aim of this study was to describe the use of mupirocin nasal irrigations for the treatment of CRS exacerbations due to MRSA. Charts of patients who received mupirocin nasal irrigations for MRSA exacerbations of CRS between January 2000 and October 2003 were reviewed. Forty-two MRSA-positive cultures were obtained from 24 patients (mean age, 61 years; range, 38-82 years; 15 women and 6 men). Twenty-eight episodes were treated with mupirocin nasal irrigations and doxycycline; 4 were treated with mupirocin nasal irrigations and trimethoprim-sulfamethoxazole, and 7 episodes were treated with mupirocin nasal irrigations alone. Patients were reevaluated at approximately 4 to 6 weeks. Repeat cultures were not obtained in 12 patients (because of clinical and endoscopic resolution). Adequate follow-up was unavailable for 3 patients, and of...Continue Reading

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