According to the findings of this systematic review, mupirocin ointment results in a statistically significant reduction in S. aureus infections in people who are nasal carriers of S. aureus.

The review included 9 RCTs (n= 3396) comparing nasal mupirocin with no treatment or placebo or alternative nasal treatment in nasal S. aureus carriers. The nosocomial S. aureus infections included bacteraemia, exit-site infections, peritonitis, respiratory tract infections, skin infections, surgical site infections (SSI) and urinary tract infections. The primary outcome was S. aureus infection rate at any site and secondary outcomes were time to infection, mortality, adverse events and infection rate caused by micro-organisms other than S. aureus. The following findings were reported:

• Data pooled from the 8 studies comparing mupirocin with placebo or with no treatment indicated a statistically significant reduction in the rate of S. aureus infection associated with intranasal mupirocin (RR 0.55, 95% CI 0.43 to 0.70).

• A planned subgroup analysis of surgical trials showed a reduction in the rate of nosocomial S. aureus infection rate associated with mupirocin use (0.55, 0.34 to 0.89) however this effect disappeared if the analysis only included surgical site infections caused by S. aureus, possibly due to a lack of power.

• The infection rate caused by micro-organisms other than S. aureus was higher in patients treated with mupirocin compared with control patients (1.38, 1.118 to 1.72).