Comparison Between Mupirocin And Other Drugs For Preventing Peritoneal Dialysis Related Infections

ObjectiveTo find out whether there are drugs as effective as mupirocin for prevention of exit-site infection (ESI) and peritonitis in peritoneal dialysis (PD) patients, thus providing more choices for preventing infection clinically.MethodsMEDLINE, the Cochrane Database, EMBASE and the Science Citation Index were searched for randomized controlled trials (RCTs) or self controlled study that met the inclusion criteria. Comparison of mupirocin and other drugs in the prevention of ESI and peritonitis were done by using RevMan4.2.ResultsSix studies and a total of537patients versus532controls were included in the analysis. The overall ESI rates, the total peritonitis rates and the peritonitis rates due to S.aureus were similar in the two groups (p=0.28, P=0.06, P=0.53). However.mupirocin decreased the risk by47%(95%CI:0.10-0.69) in ESI due to S.aureus. Analyses on subgroups of mupirocin and gentamin groups indicated the same results. The total ESI rates, the peritonitis rates and rates of peritonits due to S.aureus were similar in the two subgroups (p=0.87, p=0.21, p=0.31). But mupirocin decreased the risk by63%(95%CI:0.23-0.82) in ESI due to S.aureus.ConclusionsNo superior drugs are found in preventing total ESI and peritonitis of PD related peritonitis in patients. But in provention ESI due to S.aureus, mupirocin was superior to other drugs. Clinically,mupirocin is stil recommended as the optimal prevention strategy. Larger, multicenter, high quality RCTs are need to further confirm it.