Effect of sodium fusidate and ofloxacin on Staphylococcus aureus colonization and infection in patients on continuous ambulatory peritoneal dialysis.
The effectiveness of sodium fusidate and ofloxacin to eliminate nasal and catheter exit-site Staphylococcus aureus colonization and to prevent infections was compared in 31 patients on continuous ambulatory peritoneal dialysis (CAPD). In a prospective randomized study, 9 patients were treated with topical 2% sodium fusidate ointment applied in the anterior nares and in the pericatheter skin twice daily for 5 days; 9 subjects received oral ofloxacin 200 mg taken every 48 hours for 5 days and 13 subjects were in the control group. Treatment courses were repeated at one-month intervals. Mean duration of follow-up was 7.8 months (242 patients-month). Follow-up samples from the nares and the catheter exit-site were obtained every month from all participants to determine the presence of S. aureus. Development of S. aureus exit-site infection and peritonitis were assessed. During the study, S. aureus was recovered from 45%, 59% and 52% of the samples from the nares and/or exit-site in the sodium fusidate, ofloxacin and control groups, respectively (p = 0.13). S. aureus grew less frequently (p < 0.01) in samples from the exit-site in the sodium fusidate than in the other two groups. Eradication of nasal colonization (two negative cultures within one month) was observed in 43%, 40% and 33% of the cases in the sodium fusidate, ofloxacin and control groups, respectively (p > 0.50). The corresponding figures for exit-site eradication were 43%, 33% and 11%, respectively (p = 0.34). Twenty-four S. aureus-associated infection episodes (12 of exit-site and 12 of peritonitis) were diagnosed in 16 of the 31 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Sesso
R
R
Division of Nephrology, Escola Paulista de Medicina, São Paulo, Brazil.
Parisio
K
K
Dalboni
A
A
Rabelo
T
T
Barbosa
D
D
Cendoroglo
M
M
Pignatari
A
A
Draibe
S
S
Ajzen
H
H
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D005672:Fusidic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology; D015242:Ofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013207:Staphylococcal Skin Infections / Q000453:epidemiology / Q000517:prevention & control*
D005672:Fusidic Acid; D015242:Ofloxacin