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Staphylococcus aureus and intra‐nasal mupirocin in patients receiving isotretinoin for acne
Author(s) -
WILLIAMS R.E.A.,
DOHERTY V.R.,
PERKINS W.,
AITCHISON T.C.,
MACKIE R.M.
Publication year - 1992
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1992.tb00679.x
Subject(s) - mupirocin , isotretinoin , medicine , staphylococcus aureus , acne , dermatology , placebo , nose , anterior nares , micrococcaceae , randomized controlled trial , incidence (geometry) , surgery , methicillin resistant staphylococcus aureus , pathology , bacteria , biology , alternative medicine , optics , genetics , physics
Summary Thirty patients commencing isotretinoin for acne were entered into a double‐blind, randomized, placebo‐controlled trial to investigate the effect of pulsed intra‐nasal mupirocin ointment on Staphylococcus aureus colonization and isotretinoin‐related side‐effects. In both mupirocin and placebo groups there was an increase in isolation of S. aureus throughout the period of treatment with isotretinoin from the anterior nares, facial skin and lips. However, these increases were significantly less in the mupirocin‐treated group. A high proportion of all patients suffered inflammatory side‐effects of isotretinoin such as cheilitis and nasal vestibulitis, with their maximum severities being recorded 2 months after starting isotretinoin. In spite of the smaller increase in S. aureus colonization in the mupirocin‐treated group no difference was demonstrated in either the incidence of specific S. aureus infections (e.g. furunculosis) or the prevalence of isotretinoin‐related inflammatory side‐effects. Furthermore, no relationship between the presence of S. aureus and the severity of inflammatory side‐effects was shown. Streptococcus species were isolated on four separate occasions from four different patients during the study but their pathogenicity was unclear. These findings suggest that although pulsed intra‐nasal mupirocin produces a significant reduction in isotretinoin‐related staphylococcal colonization, its routine use cannot be justified on the basis of clinical benefit.