Comparison of topical mupirocin and gentamicin in the prevention of peritoneal dialysis-related infections: A systematic review and meta-analysis

Am J Surg. 2018 Jan;215(1):179-185. doi: 10.1016/j.amjsurg.2017.03.005. Epub 2017 Mar 15.

Abstract

Background: Topical antibiotics have been shown to reduce exit-site infection and peritonitis. The aim of this study was to compare infection rates between mupirocin and gentamicin.

Methods: Multiple comprehensive databases were searched systematically to include relevant randomized controlled trials and observational studies. Pooled risk ratios (RRs) and 95% confidence intervals were calculated for the incidences of exit-site infection and peritonitis.

Results: Seven studies (mupirocin group n = 458, gentamicin group n = 448) were analyzed for exit-site infection. The risk of gram-positive exit-site infection was similar between the groups. Gram-negative exit-site infection rate was higher in the mupirocin group (RR = 2.125, P = 0.037). Six studies were assessed the peritonitis risk. There was no difference in the gram-positive and -negative peritonitis rate.

Conclusions: Topical use of gentamicin is associated with fewer exit-site infections caused by gram-negative organisms. Gentamicin has comparable efficacy to mupirocin for peritonitis and gram-positive exit-site infection.

Keywords: Exit-site infection; Gentamicin; Mupirocin; Peritoneal dialysis; Peritonitis.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Administration, Topical
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / methods*
  • Catheter-Related Infections / etiology
  • Catheter-Related Infections / prevention & control*
  • Gentamicins / therapeutic use*
  • Gram-Negative Bacterial Infections / etiology
  • Gram-Negative Bacterial Infections / prevention & control
  • Gram-Positive Bacterial Infections / etiology
  • Gram-Positive Bacterial Infections / prevention & control
  • Humans
  • Models, Statistical
  • Mupirocin / therapeutic use*
  • Peritoneal Dialysis / adverse effects*
  • Peritonitis / prevention & control*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Mupirocin