title: Tea tree oil (5%) body wash versus standard care (Johnson's Baby Softwash) to prevent colonization with methicillin-resistant Staphylococcus aureus in critically ill adults: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether the daily use of 5% tea tree oil (TTO) body wash (Novabac 5% Skin Wash) compared with standard care [Johnson's Baby Softwash (JBS)] had a lower incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization.
  
  
  METHODS
  The study setting was two intensive care units (ICUs; mixed medical, surgical and trauma) in Northern Ireland between October 2007 and July 2009. The study population comprised 391 patients who were randomized to JBS or TTO body wash.
  
  
  METHODS
  This was a Phase 2/3, prospective, open-label, randomized, controlled trial.
  
  
  BACKGROUND
  ISRCTN65190967. The primary outcome was new MRSA colonization during ICU stay. Secondary outcomes included the incidence of MRSA bacteraemia and maximum increase in sequential organ failure assessment score.
  
  
  RESULTS
  A total of 445 patients were randomized to the study. After randomization, 54 patients were withdrawn; 30 because of a positive MRSA screen at study entry, 11 due to lack of consent, 11 were inappropriately randomized and 2 had adverse reactions. Thirty-nine (10%) patients developed new MRSA colonization (JBS n = 22, 11.2%; TTO body wash n = 17, 8.7%). The difference in percentage colonized (2.5%, 95% CI - 8.95 to 3.94; P = 0.50) was not significant. The mean maximum increase in sequential organ failure assessment score was not significant (JBS 1.44, SD 1.92; TTO body wash 1.28, SD 1.79; P = 0.85) and no study patients developed MRSA bacteraemia.
  
  
  CONCLUSIONS
  Compared with JBS, TTO body wash cannot be recommended as an effective means of reducing MRSA colonization.
authors.affiliation: Queen's University Belfast, Centre for Infection & Immunity, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland. b.blackwood@qub.ac.uk
authors.forename: Bronagh
authors.initials: B
authors.lastname: Blackwood
authors.forename: Gillian
authors.initials: G
authors.lastname: Thompson
authors.forename: Ronan
authors.initials: R
authors.lastname: McMullan
authors.forename: Michael
authors.initials: M
authors.lastname: Stevenson
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Riley
authors.forename: Fiona A
authors.initials: FA
authors.lastname: Alderdice
authors.forename: T John
authors.initials: TJ
authors.lastname: Trinder
authors.forename: Gavin G
authors.initials: GG
authors.lastname: Lavery
authors.forename: Danny F
authors.initials: DF
authors.lastname: McAuley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016470:Bacteremia / Q000382:microbiology / Q000517:prevention & control; D002353:Carrier State / Q000382:microbiology / Q000517:prevention & control*; D016638:Critical Illness; D004202:Disinfectants / Q000008:administration & dosage*; D004203:Disinfection / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009660:Northern Ireland; D013203:Staphylococcal Infections / Q000517:prevention & control*; D020947:Tea Tree Oil / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004202:Disinfectants; D020947:Tea Tree Oil