Mupirocin Cream Is as Effective as Oral Cephalexin in the Treatment of Secondarily Infected Wounds

Journal of Family Practice, Dec, 1998 by Stephen J. Kraus, Lawrence J. Eron, Gerald W. Bottenfield, Margaret A. Drehobl, William D. Bushnell, Michael A. Cupo

Pretherapy Pathogens isolated from >1% of Mupirocin-Treated Patients (Bacteriologic per Protocol Population at Follow-Up)

                                 Mupirocin
                                 Cream(*)    Cephalexin([double
                                              dagger])
                                 N = 357      N = 349
Pathogen                         no. (%)      no. (%)

Staphylococcus aureus           64 (47.1)    53 (35.8)
Group A Streptococcus            11 (8.1)     9  (6.1)
Acinetobacter Iwoffi              6 (4.4)     1  (0.7)
Klebsiella oxytoca                4 (2.9)     1  (0.7)
Acinetobacter baumannii           3 (2.2)     6  (4.1)
Moraxella species                 3 (2.2)     4  (2.7)
Enterobacter cloacae              3 (2.2      6  (4.1)
Enterobacter agglomerans          3 (2.2)     3  (2.0)
Stenotrophomonas maltophilia      3 (2.2)     2  (1.4)
Agrobacterium radiobacter         2 (1.5)         0
Pseudomonas fluorescens           2 (1.5)     1  (0.7)
Acinetobacter junii/johnsonii     2 (1.5)     4  (2.7)
Bacillus species                  2 (1.5)     7  (4.7)
Enterobacter aerogenes            2 (1.5)         0
Group B Streptococcus             2 (1.5)     4  (2.7)
Flavimonas oryzihabitans          2 (1.5)     5  (3.4)
Proteus mirabilis                 2 (1.5)         0

                               Total([double dagger])
                                      N = 706
Pathogen                              no. (%)

Staphylococcus aureus               117 (41.2)
Group A Streptococcus                 20 (7.0)
Acinetobacter Iwoffi                   7 (2.5)
Klebsiella oxytoca                     5 (1.8)
Acinetobacter baumannii                9 (3.2)
Moraxella species                      7 (2.5)
Enterobacter cloacae                   9 (3.2)
Enterobacter agglomerans               6 (2.1)
Stenotrophomonas maltophilia           5 (1.8)
Agrobacterium radiobacter              2 (0.7)
Pseudomonas fluorescens                3 (1.1)
Acinetobacter junii/johnsonii          6 (2.1)
Bacillus species                       9 (3.2)
Enterobacter aerogenes                 2 (0.7)
Group B Streptococcus                  6 (2.1)
Flavimonas oryzihabitans               7 (2.5)
Proteus mirabilis                      2 (0.7)

(*) Total pathogens = 136; total patients with at least 1 pretherapy pathogen = 98.

([dagger]) Total pathogens = 148; total patients with at least 1 pretherapy pathogen = 92.

([double dagger]) Total pathogens = 284: total patients with at least 1 pretherapy pathogen = 190.

Bacteriologic success was achieved in 97% of the patients who received mupirocin cream and 99% of patients who received cephalexin (95%, CI, -6.0% - 2.0%, P = .22) (Table 2). Superinfecting pathogens appeared in 3 patients (4 pathogens) in the mupirocin cream group and 1 patient (3 pathogens) in the cephalexin group. In the mupirocin cream group one isolate each of Aeromonas caviae, Ochrobium anthoropi, Pseudomonas aeruginosa, and Serratia liquifaciens and in the cephalexin group one isolate each of Enterobacter cloacae, S aureus, and group B Streptococcus appeared as superinfecting pathogens.