The Efficacy of an Alcohol-based Nasal Antiseptic versus Mupirocin or Iodophor for Preventing Surgical Site Infections - A Meta-analysis
Abstract
BACKGROUND
Nasal decolonization of Staphylococcus aureus is a proven strategy to reduce surgical site infections (SSI). Recently updated guidelines expanded nasal decolonization beyond traditionally high-risk populations to include the option for alcohol-based antiseptics (ABA). We assessed the efficacy of a novel ABA for reducing SSI compared to mupirocin and iodophor.
METHODS
A literature search in Google Scholar, PubMed, MEDLINE, and Cochrane databases was completed of studies reporting SSI outcomes in hospitals using an ABA. Primary meta-analyses were conducted to analyze ABA clinical efficacy versus no intervention (seven studies); sub-analyses compared the ABA to mupirocin (three studies) or iodophor (two studies).
RESULTS
147 nasal decolonization titles for SSI prevention were identified, of which seven were accepted. In the studies selected, 16,212 patients were included: 7983 (49.24%) control group, and 8129 (50.14%) intervention group. Significant effect sizes (measured as odds ratios [OR]) and z scores were found in all three meta-analyses: (OR = 3.178, z = 4.743, p < 0.001) in ABA clinical efficacy, (OR = 4.110, z = 3.167, p < 0.01), in ABA versus mupirocin, and (OR = 3.043, z = 3.155, p < 0.01) in ABA versus iodophor. Funnel plots for each demonstrated a lack of bias.
CONCLUSIONS
Statistically significant positive effects were identified in all three meta-analyses. An ABA appears to be a superior alternative to mupirocin or iodophors to reduce SSIs.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 16,212 participants or records.
Read the paper
Related studies
- Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
- A meta‐analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale
- Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
- Exercise interventions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials
- Prognostic Significance of Carbonic Anhydrase IX Expression in Cancer Patients: A Meta-Analysis
- Glucocorticoid Resistance: Is It a Requisite for Increased Cytokine Production in Depression? A Systematic Review and Meta-Analysis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.