Mupirocin Nasal Irrigation Following Endoscopic Sinus Surgery: A Prospective, Double-Blinded, Placebo-Controlled Trial.
Mohammad H Al-Bar, Abdulsalam Alqutub, Jose W Ruiz et al.
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In 30 seconds
This prospective, randomized, double-blinded, placebo-controlled trial evaluated postoperative mupirocin irrigation in adults with chronic rhinosinusitis undergoing endoscopic sinus surgery. Participants received mupirocin 0.05% or saline irrigation twice daily for 21 days; 56 of 68 enrolled patients completed follow-up. Both groups improved in SNOT-22 and visual analog scale scores, with no significant between-group differences. At 1 month, mupirocin was associated with less endoscopic mucosal edema and polyp formation, more negative postoperative cultures, and reduced need for systemic oral antibiotics. The study found no additional patient-reported quality-of-life benefit.
Key findings
- SNOT-22 and visual analog scale scores improved in both groups, without significant between-group differences.
- At 1 month, the mupirocin group had significantly lower rates of endoscopic mucosal edema and polyp formation.
- Negative postoperative cultures were more frequent and systemic oral antibiotic use was lower with mupirocin.
- No significant group differences were observed in crusting, granulation tissue, purulence, steroid use, or pain medication requirements.
Why it matters
The trial distinguishes patient-reported recovery from early endoscopic and microbiological outcomes: mupirocin did not improve reported quality of life beyond saline, but findings suggest possible benefits for early inflammation and bacterial culture results. These outcomes may inform evaluation of postoperative irrigation strategies, while the need for larger studies limits confidence in the apparent benefits.
What to keep in mind
Only 56 of 68 enrolled patients completed follow-up, and outcomes were assessed within the first 3 months. The authors call for larger studies with longer follow-up.