Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: A Randomized Clinical Trial

RCT (233 ICUs, 801,668 admissions) found nasal iodophor (e.g. povidone iodine) decolonisation did not meet non-inferiority criteria vs nasal mupirocin decolonisation for S. aureus clinical cultures or bloodstream infections, when given with daily chlorhexidine bathing.

SPS commentary:

The rate of S aureus clinical isolates in the intervention vs baseline periods was 1.17 for iodophor (raw rate: 5.0 vs 4.3/1000 ICU-attributable days) and 0.99 for mupirocin (4.1 vs 4.0/1000 ICU-attributable days). As compared to the rate for iodophor, the rate was significantly lower by 18.4% [95% CI, 10.7%-26.6%] for mupirocin.

Journal of the American Medical Association