Clinical Microbiology and Antimicrobial Chemotherapy. 2007; 9(1):57-65
The aim of this study was to assess clinical efficacy of topical chloramphenicol in comparison to topical mupirocin in the treatment of mild to moderate communityacquired skin and soft tissue infections (SSTI). A total of 150 adult immunocompetent patients (109 men, 41 women) with mild to moderate SSTI aged from 17 to 80 years were randomized to receive either topical 0.75% chloramphenicol ointment (n=50) or 2% mupirocin ointment (n=100) three times daily. Deep swabs were performed in all patients before the start of antibacterial therapy. Identification of pathogens and susceptibility testing were performed according to CLSI/NCCLS guidelines (2005). The cure rate was significantly lower in chloramphenicol group compared to mupirocin group (80% vs. 97%, respectively; p=0.01) on day 7-9, but almost similar on day 15–17 (96% vs. 100%; p=0.1). The mean time to clinical cure was 7±2.2 days for patients who received chloramphenicol compared to 4.4±1.8 days for those who received mupirocin (p<0.0001). The main causative agents of SSTI were Staphylococcus aureus (61.4%) and Streptococcus pyogenes (35.7%). Only 66.9% of S. aureus strains and 81% of S. pyogenes strains were susceptible to chloramphenicol, while all isolated strains were susceptible to mupirocin. Topical mupirocin was significantly more effective as compared to topical chloramphenicol in the treatment of community-acquired SSTI, was associated with more rapid recovery (less time to clinical cure) and therefore can be recommended for the treatment of this group of infections.