Preoperative nasal decolonization using mupirocin vs neomycin vs placebo intranasal ointment and prevention of surgical site infection among adult patients undergoing cardiac surgery

Title: Preoperative nasal decolonization using mupirocin vs neomycin vs placebo intranasal ointment and prevention of surgical site infection among adult patients undergoing cardiac surgery

Abstract:

Purpose: To evaluate the effectiveness of 2% mupirocin vs 0.5% neomycin vs placebo intranasal ointment on prevention of surgical site infections (SSIs) among adult patients undergoing cardiac surgery.
Materials and methods: In this randomized double-blinded placebo-controlled multi-arm trial, 180 adult patients undergoing cardiac surgery received preoperative nasal decolonization using 2% mupirocin or 0.5% neomycin or 0.9% normal saline (NS) as the placebo intervention, at the time of admission to the hospital and 2 h before the surgery. The effectiveness of the type of intervention was compared between the three groups using the Southampton Scoring System, and logistic regression was performed to assess the individual effect of the intervention on SSI.
Results: The study found that 2% mupirocin was more effective in reducing the incidence and severity of SSI compared to placebo at p=0.008*. No significant difference was found in the effectiveness of 0.5% neomycin vs placebo intranasal ointment (at p=0.270) and effectiveness of 2% mupirocin vs 0.5% neomycin at p=0.138. The incidence of SSI was reported higher in the control group (45.50%) than the neomycin group (27%) and the least was reported in the mupirocin group (15%).
The risk of SSI in group 1 (mupirocin) was significantly lower than in the control group (risk ratio (RR)=0.35; 95% confidence interval (CI): 0.17–0.68; p<0.01). Similarly, group 2 (neomycin) also showed a reduction in risk compared to the control (RR=0.60; 95% CI: 0.30–1.10; p ≈ 0.05) suggesting that both mupirocin and neomycin may be effective in reducing the incidence of SSIs, with mupirocin demonstrating a stronger and statistically significant effect.
Conclusion: Preoperative nasal decolonization using 2% mupirocin intranasal ointment was effective in reducing the incidence and severity of SSIs among adult patients undergoing cardiac surgery.

Biography:

Ms. Pooja Thakur, RN RM, is a distinguished nursing professional with nine years of advanced clinical experience in the Cardiothoracic and Vascular Surgery (CTVS) unit, where she has consistently demonstrated excellence in high-acuity patient care. A double Gold Medalist, she earned her MSc Nursing (Critical Care) from AIIMS New Delhi and BSc Nursing from Himachal Pradesh University, reflecting her outstanding academic merit. She also holds a Master’s degree in Clinical Psychology from IGNOU, enriching her holistic approach to patient care. Renowned for her expertise in critical care nursing, strong communication skills, and commitment to evidence-based practice, she has contributed significantly to nursing research, with publications indexed in PubMed.