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Poovelikunnel, TT,Gethin, G,Solanki, D,McFadden, E,Codd, M,Humphreys, H
2018
February
J Hosp Infect
Randomized controlled trial of honey versus mupirocin to decolonize patients with nasal colonization of meticillin-resistant Staphylococcus aureus
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Meticillin-resistant Staphylococcus aureus Medical-grade honey Antimicrobial resistance Decolonization DIABETIC FOOT ULCERS MANUKA HONEY CONTACT PRECAUTIONS CLINICAL-TRIAL ACUTE-CARE MRSA TRANSMISSION EFFICACY CARRIAGE ERADICATION
98
141
148
Background: Mupirocin is used specifically for the eradication of nasal meticillin-resistant Staphylococcus aureus (MRSA), but increasing mupirocin resistance restricts its repeated use. The antibacterial effects of manuka honey have been established in vitro; antibacterial activity of other honeys has also been reported.Aim: To describe the learning experience from a randomized controlled trial (RCT) comparing the efficacy of medical-grade honey (MGH) with mupirocin 2% for the eradication of nasal MRSA.Methods: Patients colonized in the nose with MRSA and age >= 18 years were recruited. Participants received either one or two courses of MGH or mupirocin 2%, three times per day for five consecutive days.Findings: The proportion of patients who were decolonized after one or two courses of treatment was not significantly different between MGH [18/42; 42.8%; 95% confidence interval (CI): 27.7-59.0] and mupirocin 2% (25/44; 56.8%; 95% CI: 41.0-71.7). Non-nasal MRSA colonization was significantly associated with persistent nasal colonization (odds ratio: 5.186; 95% CI: 1.736-5.489; P = 0.003). The rate of new acquisition of mupirocin resistance was 9.75%.Conclusion: Although not significant, a decolonization rate of 42.8% for MGH was impressive. Our findings suggest that this strategy, which has the potential to combat antimicrobial resistance, should be assessed in similar but larger studies. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
10.1016/j.jhin.2017.10.016
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