A randomized controlled trial comparing mupirocin versus Polysporin Triple for the prevention of catheter-related infections in peritoneal dialysis patients (the MP3 study).
BACKGROUND
Peritonitis remains the most serious complication of peritoneal dialysis (PD). Gram-positive organisms are among the most common causes of PD peritonitis; however, recent trends show increasing rates of gram-negative and fungal infections. Strategies to prevent peritonitis include the use of prophylactic topical mupirocin at the site where the PD catheter exits from the abdominal wall; however, mupirocin does not afford protection against gram-negative or fungal infections. The aim of this study is to determine if the incidence of catheter-related infections (exit-site infection, tunnel infection, or peritonitis) is significantly reduced by the routine application of Polysporin Triple antibiotic ointment (Pfizer Canada, Markham, Ontario, Canada) in comparison to mupirocin ointment.


METHODS
The Mupirocin Versus Polysporin Triple Study (MP3) is a multicenter, randomized, double-blinded controlled study comparing Polysporin Triple (P3) against the current standard of care. The aim of the study is to recruit 200 patients being treated with or starting on PD and randomize them to receive either mupirocin or P3 at the catheter exit site. Patients will be followed for 18 months or until death or transfer from PD to an alternate treatment modality. The primary outcome will be the time to first catheter-related infection. Catheter-related infections will be strictly defined using current guidelines and categorized into exit-site infections, infective peritonitis, or tunnel infections. The primary analysis will be an intention-to-treat analysis.


CONCLUSIONS
The results of this study will help determine if the use of P3 is superior to mupirocin ointment in the prevention of catheter-related infections and will help guide evidence-based best practices.
Jassal
Sarbjit V
SV
Department of Medicine, University of Toronto, and Division of Nephrology, University Health Network, Toronto, Ontario, Canada. vanita.jassal@uhn.on.ca
Lok
Charmaine E
CE
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001414:Bacitracin / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D004338:Drug Combinations; D006096:Gramicidin / Q000627:therapeutic use*; D006801:Humans; D016712:Mupirocin / Q000627:therapeutic use*; D018579:Patient Selection; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000517:prevention & control; D011112:Polymyxin B / Q000627:therapeutic use*; D018401:Sample Size
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; C420142:polysporin ointment; D001414:Bacitracin; D006096:Gramicidin; D016712:Mupirocin; D011112:Polymyxin B