Prevention of Surgical Site Infections: Effectiveness of Nasal Povidone-Iodine and Nasal Mupirocin
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Purpose
We hypothesize the application of mupirocin or povidone-iodine to the nares is equally effective in short term Staphylococcus aureus(SA)suppression. Our overall study objective is to measure the rate of deep and superficial Surgical Site Infections (SSIs) after primary hip, knee, shoulder and elbow arthroplasty surgery and primary spinal fusion surgery requiring implantation of prosthetic material, when the patient receives either nasal mupirocin or nasal povidone-iodine prior to surgery.
Secondary study objectives include:
- Measure hospital length of stay and re-admission rates in the mupirocin and povidone-iodine groups.
- Measure adverse events related to mupirocin and povidone-iodine.
- Measure rate of SA resistance to mupirocin.
| Condition | Intervention | Phase |
|---|---|---|
|
Surgical Site Infection |
Drug: mupirocin calcium ointment, 2% Drug: Povidone-iodine solution 5% w/w (0.5% available iodine) Patient Preoperative Skin Preparation |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Prevention |
- Measure the rate of deep and superficial surgical site infections after primary orthopedic surgery and primary spinal fusion surgery requiring implantation of prosthetic material, when the patient receives either product prior to surgery. [ Time Frame: 12 months ] [ Designated as safety issue: No ]Infections counted if within 12 months of surgical procedure
- Measure hospital length of stay and re-admission rates in the mupirocin and povidone-iodine groups. [ Time Frame: 12 months ] [ Designated as safety issue: No ]Re-admission for infection within 12 months of procedure
- Measure adverse events related to mupirocin and povidone-iodine. [ Time Frame: At time of treatment ] [ Designated as safety issue: Yes ]Patients were given an adverse event log to complete after treatment
- Measure rate of Staphylococcus aureus resistance to mupirocin. [ Time Frame: Isolates collected and frozen ] [ Designated as safety issue: No ]Lab will culture isolates when time and money permit
| Enrollment: | 1784 |
| Study Start Date: | March 2011 |
| Study Completion Date: | September 2012 |
| Primary Completion Date: | September 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 3M Skin and Nasal Antiseptic
Povidone-iodine solution 5% w/w (0.5% available iodine) USP Patient Preoperative Skin Preparation
|
Drug: Povidone-iodine solution 5% w/w (0.5% available iodine) Patient Preoperative Skin Preparation
The solution is applied to for 30 seconds to each nostril twice for a total of 2 minutes. The solution is applied by rotating the applicator around the circumference of the nostril for 15 seconds and then rotating the applicator in the anterior nares for 15 seconds.
Other Name: 3M Skin and Nasal Antiseptic
|
|
Active Comparator: Bactroban Nasal
Mupirocin calcium ointment, 2%
|
Drug: mupirocin calcium ointment, 2%
Approximately one-half of the ointment from the single-use tube should be applied into 1 nostril and the other half into the other nostril twice daily (morning and evening) for 5 days. After application, the nostrils should be closed by pressing together and releasing the sides of the nose repetitively for approximately 1 minute. This will spread the ointment throughout the nares. Other Name: Bactroban Nasal
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Primary arthroplasty or spinal fusion surgery
- Age greater than 18 years
Exclusion Criteria:
- Revision arthroplasty
- Revision spinal fusion surgery
- Primary spine surgery without implantation of prosthetic material
- Allergy to mupirocin
- Allergy to povidone-iodine
- Pregnancy
- Breastfeeding
Contacts and Locations| United States, New York | |
| NYU Langone Medical Center | |
| New York, New York, United States, 10003 | |
| Principal Investigator: | Michael Phillips, MD | NYU Langone Center |
More Information
No publications provided
| Responsible Party: | 3M |
| ClinicalTrials.gov Identifier: | NCT01313182 History of Changes |
| Other Study ID Numbers: | 11318 |
| Study First Received: | February 11, 2011 |
| Last Updated: | June 11, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Anti-Infective Agents, Local Iodine Cadexomer iodine Povidone-Iodine Povidone Mupirocin Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Plasma Substitutes |
Blood Substitutes Hematologic Agents Trace Elements Micronutrients Growth Substances Physiological Effects of Drugs Protein Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on June 17, 2013