Patient experience with mupirocin or povidone-iodine nasal decolonization

Area of Science:

• Healthcare Policy
• Infectious Disease Prevention
• Patient Safety

Background:

• Healthcare payers are shifting reimbursement towards quality of care.
• Nasal decolonization is a strategy to reduce surgical site infections (SSIs).
• Comparing patient experience with different nasal decolonization agents is crucial for adherence and satisfaction.

Purpose of the Study:

• To compare patient experiences and satisfaction with nasal povidone-iodine (PI) versus nasal mupirocin ointment (MO) for preoperative decolonization.
• To evaluate adverse events associated with each decolonization method.
• To assess patient perceptions of SSI prevention participation.

Main Methods:

• 1903 patients were randomized to receive either nasal PI or nasal MO, along with chlorhexidine wipes.
• Patient interviews were conducted prior to discharge to assess adverse events and experiences.
• Statistical analysis compared outcomes between the PI and MO groups.

Main Results:

• Significantly fewer patients reported unpleasant experiences with nasal PI (3.4%) compared to nasal MO (38.8%).
• Nasal PI group reported significantly fewer adverse events than the nasal MO group.
• Over two-thirds of patients in both groups found their assigned nasal decolonization method helpful for SSI prevention.

Conclusions:

• Nasal povidone-iodine offers a superior patient experience and safety profile compared to nasal mupirocin ointment for preoperative nasal decolonization.
• Both nasal PI and MO are perceived as helpful interventions for SSI prevention.
• Patient satisfaction and reduced adverse events are key considerations in selecting preoperative decolonization agents.