A feasibility study comparing topical use of acetic acid at the exit site versus mupirocin to prevent exit site infections in peritoneal dialysis patients.
Mrs Lesley Williams
70 participants
Feb 13, 2018
Interventional
Conditions
Summary
PD catheter ESI is a major predisposing factor to PD peritonitis and resultant catheter and modality failure. The two most frequent causative organisms of ESI are Staphylococcus aureus (SA) and Pseudomonas aeruginosa. Daily topical application of an antibiotic cream such as mupirocin is the standard of care, however this agent is not anti-pseudomonal and may promote antibiotic resistance. Acetic acid at low concentrations is non=toxic to humans and non-irritant, but has broad antimicrobial activity including against Pseudomonas aeruginosa and may therefore offer a cheap and effective alternative. It has a long history in chronic wound care for this purpose. In this trial we will investigate the feasibility of the use of daily acetic acid dressings to reduce exit site infection, in comparison to the use of standard mupirocin treatment.
Eligibility
Inclusion Criteria3
- All adult patients undergoing peritoneal dialysis under the catchement area of the Royal Brisbane and Women's Hospital.
- No active peritonitits or exit site infection.
- Ability to comply with exit site cares.
Exclusion Criteria2
- Active infection.
- Inability to comply with exit site cares.
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Interventions
Group 1 (intervention): routine exit site cleaning + topical acetic acid Group 2(control group - standard care): routine exit site cleaning + topical mupirocin Routine exit site (ES) cleaning involves: Cleaning ES in the shower with a packet of sterile gauze with antibacterial soap and water, drying the ES after the shower with sterile gauze then sunning ES for 10 minutes where possible. Topical mupirocin involves: application of small amount (approx.. 1/4 pea size) of Mupirocin ointment 2% with cotton tip, after cleaning and sunning of ES (as described above). Topical acetic acid involves: application of sterile gauze soaked with 2% acetic acid (approximately 5ml) for 10 minutes contact time to the ES after cleaning and sunning of ES as above. Exit site cares (including the intervention and control treatment) are performed daily in the morning and for the duration of the trial (12 months). Exit site cares are administered by the patient.
Locations(1)
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ACTRN12617001286336