Comparison of Gentamicin Ointment to Mupirocin Ointment for Prevention of Peritoneal Dialysis Catheter-Related Infections

In July 2007, all peritoneal dialysis (PD) patients in our hospital were switched from mupirocin to gentamicin ointment for daily application to the PD catheter exit site (CES). Our objective was to compare the efficacy of gentamicin and mupirocin in the prevention of catheter-related PD infections. We conducted an observational sequential cohort study to compare infectious outcomes with the 2 ointments. Mupirocin patients were followed retrospectively from January 2004 to June 2006 and gentamicin patients prospectively from July 2007 to December 2008. All patients were followed for 18 months following catheter insertion. Fifty-nine patients were included in the mupirocin arm and 37 patients in the gentamicin arm. Time to first infection (either CES or peritonitis) was similar between arms, with a probability of being infection-free at 12 months of 67% versus 53%, respectively (p=0.34). There were no differences in rates of overall infection (0.54 vs 0.56 infections per patient-year, respectively (p=0.94)) or peritonitis (0.41 vs 0.37 per patient-year, respectively (p=0.84). There were 5 pseudomonal infections in the mupirocin arm and none with gentamicin. It was concluded that topical gentamicin has comparable effectiveness to mupirocin for prevention of PD catheter-related infections.