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Topical Antibiotics for Infection Prevention: A Review of the Clinical Effectiveness and Guidelines

Last updated: March 30, 2017
Project Number: RC0854-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of topical antibiotics for patients to prevent skin or wound infection?
  2. What are the evidence-based guidelines regarding the use of topical antibiotics for the prevention of skin or wound infection?

Key Message

Two systematic reviews and one non-randomized study showed that in non-surgical patients, exit site infection rates were statistically significantly reduced with mupirocin compared with placebo, no treatment, historic control or standard of care.Two systematic reviews and one RCT showed that overall, in surgical patients, no statistically significant differences were observed in SSI rates with mupirocin compared with placebo, no intervention, no antibiotic, or historic control.One systematic review showed that in patients undergoing peritoneal dialysis there was no statistically significant difference in ESI with fusidate compared with no treatment.One systematic review showed that in surgical patients, there was a statistically significant reduction in SSI with bacitracin compared with no antibioticFindings need to be interpreted in the light of the limitations of the available data.Relevant evidence regarding polysporin and silver sulfadiazine was not identified. One guideline recommended the use of mupirocin for preventing surgical site infections for patients undergoing cardiothoracic or orthopedic surgery and one guideline recommended the use of mupirocin in adults undergoing intensive home hemodialysis. One guideline mentioned that the use of silver sulfadiazine in preventing burn wound infection has not been proven.