Lindgren AK, et al. – Authors conducted an open randomized study to evaluate two MRSA (Methicillin–resistant Staphylococcus aureus) throat carriage eradication protocols: one treatment group received oral rifampicin and clindamycin or trimethoprim–sulfamethoxazole for seven days, in combination with nasal mupirocin; patients in the other group were treated with nasal mupirocin, only. As per observations, a combination of rifampicin and clindamycin or trimethoprim–sulfamethoxazole proved more effective in eliminating pharyngeal MRSA carriage compared to topical treatment with mupirocin.

Methods

• Authors performed an open randomized study assessing two eradication protocols.
• They enrolled patients with pharyngeal carriage of MRSA at six Swedish centers during four years.
• Oral rifampicin and clindamycin or trimethoprim-sulfamethoxazole were administered to one treatment group for seven days, in combination with nasal mupirocin.
• Other group was treated with nasal mupirocin, only.
• Patients in the same household were randomized together.
• A hygiene protocol including chlorhexidine washings was followed by both the groups.
• They performed cultures from the nares, perineum and throat at baseline, and then two weeks, two months and six months after the end of treatment.

Results

• 28 patients were administered rifampicin-based systemic antibiotics.
• 24 subjects were there in the mupirocin only group.
• At follow-up six months after the end of treatment, negative MRSA results were obtained in 61% of the patients and 50% of the households in the systemic antibiotics group.
• In this study, significantly less patients (12%) and households (10%) became decolonized in the group receiving topical treatment only.