The Swap Out Trial is a cluster randomized controlled trial of HCA hospitals, evaluating the non-inferiority of two decolonization regimens: Arm 1 Routine Care: ICU nasal decolonization with mupirocin twice daily for 5 days in the context of chlorhexidine for daily bathing; Arm 2 Intervention: ICU nasal decolonization with iodophor twice daily for 5 days in the context of chlorhexidine for daily bathing Note: that enrolled "subjects" represents 137 individual HCA Hospitals (representing \~235 ICUs) that have been randomized.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
353,323
The intervention / decolonization regimen will consist of 5 days of topical intranasal mupirocin ointment (bilateral nares, twice daily) on ICU admission, in the context of continued daily baths with 2% chlorhexidine cloths.
The intervention / decolonization regimen will consist of 5 days of topical intranasal iodophor (10% povidone-iodine nasal swabs) (bilateral nares, twice daily) on ICU admission, in the context of continued daily baths with 2% chlorhexidine cloths.
Number of Participants With ICU-attributable Staphylococcus Aureus Clinical Cultures
Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-susceptible Staphylococcus aureus (MSSA) clinical cultures attributable to participating ICUs. Defined as occurring \>2 days into a participating ICU stay through 2 days following ICU discharge. NOTE: this outcome is intended for the primary manuscript.
Time frame: 18-month intervention
Number of Participants With ICU Attributable MRSA Clinical Cultures
Methicillin-resistant Staphylococcus aureus (MRSA) clinical cultures attributable to participating ICUs. Defined as occurring \>2 days into a participating ICU stay through 2 days following ICU discharge. NOTE: this outcome is intended for the primary manuscript.
Time frame: 18-month intervention
Number of Participants With ICU-attributable Bloodstream Infections
All-cause bloodstream infection attributable to participating ICUs. Defined as occurring \>2 days into a participating ICU stay through 2 days following ICU discharge.Includes subsets of gram positive (GP), gram negative (GN) and fungal (candida) bloodstream infections, as well as key pathogens such as S. aureus (MRSA and MSSA). NOTE: this outcome is intended for the primary manuscript.
Time frame: 18-month intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Riverside Community Hospital
Riverside, California, United States
Regional Medical Center of San Jose
San Jose, California, United States
Good Samaritan Hospital
San Jose, California, United States
Los Robles Regional Medical Center
Thousand Oaks, California, United States
West Hills Hospital & Medical Center
West Hills, California, United States
The Medical Center of Aurora
Aurora, Colorado, United States
Swedish Medical Center
Denver, Colorado, United States
Sky Ridge Medical Center
Denver, Colorado, United States
Presbyterian St. Luke's Medical Center
Denver, Colorado, United States
Rose Medical Center
Denver, Colorado, United States
...and 127 more locations