Staphylococcal Infections Clinical Trial
Official title:
Treatment of Catheter Related Bloodstream Infection Caused by Coagulase Negative Staphylococcus; Removal of Catheter Followed by 2 Days Compared With 7 Days Intravenous Vancomycin
Patients admitted into the Intensive Care Unit (ICU) have an intravenous (IV) catheter
(small plastic tube) placed in their vein. Very occasionally (4 times out of 100) the
insertion of an intravenous catheter may cause an infection in the blood. It has been shown
that the removal of the catheter and the insertion of a new one at a new site helps to get
rid of this infection. Sometimes, antibiotics are also given.
Vancomycin is the antibiotic given intravenously (into the vein) to treat these
catheter-related infections. At Vancouver General Hospital, some physicians may not give any
vancomycin at all whereas others may treat with intravenous (IV) vancomycin for one to
fourteen days.
Since there are a lack of data to support the length of IV vancomycin therapy, the
investigators would like to find out if two days of IV vancomycin are as good as seven days.
Therefore, the purpose of this study is to determine if two days of IV vancomycin are as
good as seven days for the treatment of catheter-related infections in the blood.
INTRODUCTION: Intravascular device associated bacteremia due to coagulase negative
staphylococcus has become the most common nosocomial bacteremia. Despite its prevalence, no
prospective study has investigated how these infections should be treated. Removal of the
intravascular device is associated with a reduction in recurrence rate from 20% to 3% but
the required duration of vancomycin therapy is not known. We propose to test the hypothesis
that, following removal of the intravascular device, treatment with 2 days of vancomycin is
equivalent to 7 days of vancomycin.
INTERVENTION: Randomized double-blind equivalence trial to test the hypothesis that 2 days
is equivalent to 7 days of vancomycin treatment for intravascular device associated
bacteremia due to coagulase negative staphylococcus. The definitions for the surveillance of
intravascular device associated bacteremia from the Laboratory Centre for Disease
Control-Health Canada will be used.
MEASUREMENTS: Surveillance blood cultures on days 4 and 9 following removal of intravascular
device. Relatedness of strains will be determined by pulsed-field gel electrophoresis
(PFGE).
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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