Iodine Is Inferior to Mupirocin for Nasal Decolonization in the Intensive Care Unit

Patients treated with mupirocin were less likely to have positive S. aureus cultures, but numbers of bloodstream infections were similar.

Intensive care unit (ICU) nosocomial infections with Staphylococcus aureus had plateaued in the U.S. but rose again during the COVID-19 pandemic. Although nasal decolonization with mupirocin, in conjunction with daily chlorhexidine gluconate (CHG) baths, prevents some methicillin-resistant S. aureus (MRSA) bloodstream infections (N Engl J Med 2013; 368:2255), it has not been adopted as usual care in most ICUs — likely due to concerns about creating antimicrobial resistance.

Investigators randomized 137 hospitals (233 ICUs in a single network) either to administer twice-daily mupirocin or to use povidone-iodine nasal swabs for 5 days on admission to the ICU. All patients also received daily CHG baths. All ICUs in the system had adopted standa…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Iodine Is Inferior to Mupirocin for Nasal Decolonization in the Intensive Care Unit

Topics

Reviewing Author