Randomized clinical trial: Long-term Staphylococcus aureus decolonization in patients on home parenteral nutrition

• DOI: 10.1016/j.clnu.2023.03.010
• Publication Date: 2023-03-17T16:11:07Z
• Authors: Michelle Gompelman; Guus T.J. Wezendonk; Yannick Wouters; Judith Beurskens-...; Konstantinos C. F...; Farooq Z. Rahman; Jordy P.M. Coolen; Ingrid J.M. van W...; Heiman F.L. Wertheim; Wietske Kievit; Reinier P. Akkermans; Mireille J. Serlie; Chantal P. Bleeke...; Geert J.A. Wanten
• Keywords: Regimen

Staphylococcus aureus decolonization has proven successful in prevention of S. infections and is a key strategy to maintain venous access avoid hospitalization patients receiving home parenteral nutrition (HPN). We aimed determine the most effective safe long-term regimen.A randomized, open-label, multicenter clinical trial was conducted. Adult intestinal failure with HPN support carrying were randomly assigned 'continuous suppression' (CS) strategy, repeated chronic topical antibiotic treatment or 'search destroy' (SD) short systemic treatment. Primary outcome proportion whom totally eradicated during 1-year period. Secondary outcomes included risk factors for infections, antimicrobial resistance, adverse events, patient compliance cost-effectivity.63 participants (CS 31; SD 32). The mean rate 61% (95% CI 44, 75) CS group 39% 25, 56) an OR 2.38 0.92, 6.11, P = 0.07). More effects occurred (P 0.01). Predictors eradication positive caregiver presence (gastro)enterostomy.We did not demonstrate increased efficacy over continuous suppression latter may be best option as it achieved higher well-tolerated (NCT03173053).