Prophylactic effects of global declonization with chlorhexidine and mupirocin in neutropenic fever and infection in patients with hematologic malignancies

Abstract

Fever and neutropenia complications are one of the most common problems in patients with hematologic malignancies that can interfere with standard treatment and increase mortality. The aim of this study was to evaluate the effectiveness of global decolonization with chlorhexidine and mupirocin in the prevention of fever and neutropenia in patients with acute leukemia. Methods and materials In this study, patients with acute leukemia were randomly divided into three groups (each group containing 32 patients). The first group used chlorhexidine mouthwash from two days before to 3 days after starting chemotherapy (5 days). The second group used mupirocin nasal drops from two days before to 3 days after starting chemotherapy (5 days). The third group as a control did not receive any decolonization drug. From all groups nasal swabs collected before starting drug therapy and cultured in blood agar and mannitol salt agar media and identified using phenotypic methods to evaluate the prevalence of colonization with MRSA, CONS, and Pseudomonas aeruginosa microorganisms. Results Patients that received chlorhexidine, probably lower chance with 22% to need antibiotics than controls. Patients that received mupirocin, probably lower chance with 52% to need antibiotics than controls, respectively. In addition, Patients who received chlorhexidine were less probably to have a fever with 33% than control group. Patients who received mupirocin were less probably to have a fever with 54% than control group.

Conclusion Our study showed that the use of mupirocin and chlorhexidine in patients could significantly reduce the colonization of microorganisms.