Comparison of topical mupirocin and gentamicin in the prevention of peritoneal dialysis-related infections: a systematic review and meta-analysis

Abstract Background Topical antibiotics have been shown to reduce exit-site infection and peritonitis. The aim of this study was to compare infection rates between mupirocin and gentamicin. Methods Multiple comprehensive databases were searched systematically to include relevant randomized controlled trials and observational studies. Pooled risk ratios (RRs) and 95% confidence intervals were calculated for the incidences of exit-site infection and peritonitis. Results Seven studies (mupirocin group n = 458, gentamicin group n = 448) were analyzed for exit-site infection. The risk of gram-positive exit-site infection was similar between the groups. Gram-negative exit-site infection rate was higher in the mupirocin group (RR = 2.125, P = 0.037). Six studies were assessed the peritonitis risk. There was no difference in the gram-positive and -negative peritonitis rate. Conclusions Topical use of gentamicin is associated with fewer exit-site infections caused by gram-negative organisms. Gentamicin has comparable efficacy to mupirocin for peritonitis and gram-positive exit-site infection. Table of contents Topical antibiotics reduce exit-site infection and peritonitis of peritoneal dialysis. This meta-analysis demonstrated that topical gentamicin is associated with fewer gram-negative exit-site infections. There is no difference in peritonitis and gram-positive exit-site infection.