Treatment of Patients Colonized With Methicillin-Resistant Staphylococcus Aureus Prior to Bone and Joint Surgery

Bay Pines VA Healthcare System

Overview

The investigators anticipate that utilization of retapamulin preoperatively will eliminate MRSA colonization among patients who are colonized in their nares.

Enhanced characterization of MRSA strains carried by patients and their eradication prior to surgery will significantly reduce healthcare costs to the VA by reducing the number of MRSA positive patients who need to be isolated and or closely monitored, and allow healthcare providers to better predict the patient's requirements. In addition, the application of molecular methods will facilitate faster tracking of MRSA postoperative infections.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Conditions

Orthopedic Procedures Methicillin-resistant Staphylococcus Aureus

Interventions

PlaceboDRUG

Placebo will be administered intranasally an amount approximating 0.25 ml will be applied to each nasal vestibule by sterile cotton applicator in the evening prior to surgery and immediately on call on the day of surgery.

Altabax (retapamulin)DRUG

Retapamulin 1% ointment will be administered intranasally an amount approximating 0.25 ml will be applied to each nasal vestibule by sterile cotton applicator in the evening prior to surgery and immediately on call on the day of surgery.

Eligibility

Sex: ALLHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who are admitted for an orthopedic surgical procedure * All patients will be screened and admitted to the study prior to surgery regardless of eventual culture results for MRSA Exclusion Criteria: * Pregnancy * Serious systemic illness due to renal, cardiac or hepatic disease * Inability to complete follow-up assessments * Allergy or intolerance to retapamulin * BMI \> 30 * Uncontrolled diabetes, severe anemia, thrombocytopenia or an underlying hematopoietic disorder or malignancy * Patients with serious life-threatening illnesses and those with terminal illness not expected to survive for two years or more will not be enrolled * Antibiotics administered during the course of the study will be recorded (name, dose and dates)

Locations (1)

Bay Pines VAHCS

Bay Pines, Florida, United States

Outcomes

Primary Outcomes

Evaluate efficacy of Retapamulin 1% ointment in eliminating patients MRSA colonization

Time frame: 30 days

Secondary Outcomes

Identify a predominant clone among the MRSA isolates in this study

Time frame: 2 years

Data from ClinicalTrials.gov

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