A Cochrane review included 10 studies with a total of 786 subjects. Topical antimicrobial ointment compared to no ointment or placebo reduced the risk of catheter-related bacteraemia (RR 0.26, 95 % CI 0.15 to 0.46; 5 trials, n=508). Mupirocin ointment reduced the risk of central venous catheter -related bacteraemia (RR 0.17, 95% CI 0.07 to 0.43; 3 trials, n=217) and catheter-related infections caused by S. aureus. The risk of catheter-related bacteraemia was reduced by polysporin (RR 0.40, 95% CI 0.19 to 0.86; 1 trial, n=162) and povidone-iodine ointment (RR 0.10, 95% CI 0.01 to 0.72; 1 trial, n=129). Subgroup analysis suggested a reduced all-cause mortality by polysporin ointment (3/83 vs 13/79) but not by mupirocin (0/17 vs 3/14) or povidone-iodine ointment (4/63 vs 5/66). Mortality related to infection was reduced by topical ointment compared to no ointment or placebo (RR 0.15, 95 % CI 0.03 to 0.81; 3 trials, n=322). Insufficient reporting on mupirocin resistance was noted. Topical honey did not reduce the risk of exit site infection or catheter-related bacteraemia. Transparent polyurethane dressing compared to dry gauze dressing did not reduce the risk of central venous catheter or exit site infection, or catheter-related bacteraemia.
Comment: The quality of evidence is downgraded by several shortcomings in study quality .