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

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

Author information

1
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan.
2
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan.
3
Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan.
4
Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City, Taiwan; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
5
Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan. Electronic address: surg.mmh@gmail.com.

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

PMID:
28341139
DOI:
10.1016/j.amjsurg.2017.03.005
[Indexed for MEDLINE]

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