Related Experiment Video
Updated: Aug 9, 2026
Microbiological Rapid On-Site Evaluation for Pulmonary Infectious Diseases
Published on: March 1, 2024
Treatment of chronic rhinosinusitis exacerbations due to methicillin-resistant Staphylococcus aureus with mupirocin
C Arturo Solares1, Pete S Batra, Geraldine S Hall
1The Cleveland Clinic Foundation, Head and Neck Institute, OH 44195, USA.
Introduction:
Chronic rhinosinusitis (CRS) exacerbations due to methicillin-resistant Staphylococcus aureus (MRSA) are routinely encountered. Treatment often involves intravenous antibiotics that provide only transient benefits. Mupirocin has well-recognized antistaphylococcal activity, and its nasal formulation is approved by the Food and Drug Administration for the eradication of nasal colonization with MRSA.
Objective:
The aim of this study was to describe the use of mupirocin nasal irrigations for the treatment of CRS exacerbations due to MRSA.
Materials And Methods:
Charts of patients who received mupirocin nasal irrigations for MRSA exacerbations of CRS between January 2000 and October 2003 were reviewed.
Results:
Forty-two MRSA-positive cultures were obtained from 24 patients (mean age, 61 years; range, 38-82 years; 15 women and 6 men). Twenty-eight episodes were treated with mupirocin nasal irrigations and doxycycline; 4 were treated with mupirocin nasal irrigations and trimethoprim-sulfamethoxazole, and 7 episodes were treated with mupirocin nasal irrigations alone. Patients were reevaluated at approximately 4 to 6 weeks. Repeat cultures were not obtained in 12 patients (because of clinical and endoscopic resolution). Adequate follow-up was unavailable for 3 patients, and of the 27 repeat cultures, only 1 grew MRSA. Twelve patients had at least one recurrence, with a mean number of episodes of 1.75 (range, 1-8 episodes). The mean follow-up was 11.8 months (range, 3-27 months).
Conclusions:
Mupirocin nasal irrigations may avoid the need for intravenous antibiotics, which often provide temporary benefits and entail greater cost and morbidity. Thus, mupirocin nasal irrigations may provide a relatively simple means for the management of MRSA exacerbations of CRS.
Insights
Mupirocin nasal irrigations offer a potential alternative to intravenous antibiotics for managing chronic rhinosinusitis exacerbations caused by methicillin-resistant Staphylococcus aureus (MRSA). This treatment may provide a simpler, more cost-effective approach for patients.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Pharmacology
Background:
- Chronic rhinosinusitis (CRS) exacerbations frequently involve methicillin-resistant Staphylococcus aureus (MRSA).
- Current treatments, often intravenous antibiotics, offer only temporary relief and carry significant costs and morbidity.
- Mupirocin, with proven antistaphylococcal activity, is FDA-approved for nasal MRSA eradication.
Purpose of the Study:
- To evaluate the efficacy of mupirocin nasal irrigations in treating CRS exacerbations caused by MRSA.
Main Methods:
- Retrospective chart review of patients treated with mupirocin nasal irrigations for MRSA CRS exacerbations (2000-2003).
- Analysis of treatment regimens, including combinations with doxycycline or trimethoprim-sulfamethoxazole, and mupirocin alone.
- Assessment of patient outcomes through clinical and endoscopic reevaluation, with repeat cultures where possible.
Main Results:
- Twenty-four patients with MRSA CRS exacerbations were identified.
- Of 27 repeat cultures, only one grew MRSA, indicating treatment effectiveness.
- Twelve patients experienced recurrences, with a mean of 1.75 episodes.
Conclusions:
- Mupirocin nasal irrigations may serve as an alternative to intravenous antibiotics for MRSA CRS exacerbations.
- This approach could reduce the need for costly and morbid intravenous treatments.
- Mupirocin nasal irrigations present a straightforward management option for MRSA-related CRS exacerbations.
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