title: Effect of sodium fusidate and ofloxacin on Staphylococcus aureus colonization and infection in patients on continuous ambulatory peritoneal dialysis.
abstract: 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)
authors.affiliation: Division of Nephrology, Escola Paulista de Medicina, São Paulo, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Sesso
authors.forename: K
authors.initials: K
authors.lastname: Parisio
authors.forename: A
authors.initials: A
authors.lastname: Dalboni
authors.forename: T
authors.initials: T
authors.lastname: Rabelo
authors.forename: D
authors.initials: D
authors.lastname: Barbosa
authors.forename: M
authors.initials: M
authors.lastname: Cendoroglo
authors.forename: A
authors.initials: A
authors.lastname: Pignatari
authors.forename: S
authors.initials: S
authors.lastname: Draibe
authors.forename: H
authors.initials: H
authors.lastname: Ajzen
mesh_terms: 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*
chemical_list: D005672:Fusidic Acid; D015242:Ofloxacin