Systematic review of the effectiveness of preventing and treating Staphylococcus aureus carriage in reducing peritoneal catheter-related infections
McCormack K, Rabindranath K, Kilonzo M, Vale L, Fraser C, McIntyre L, et al
Record ID 32007000524
English
Authors' objectives:
"The objectives of this review were to determine the clinical effectiveness and cost-effectiveness of alternative strategies for the prevention and eradication of Staphylococcus aureus carriage in patients on peritoneal dialysis (PD). The aim was to prevent, or reduce, the frequency of peritonitis. The review does not cover treatment of peritonitis itself."
(from executive summary)
Authors' results and conclusions:
Number and quality of studies and summary of benefits Twenty-two trials were found. These fell into several groups: the first split is between prophylactic trials, aiming to prevent carriage, and trials which aimed to eradicate carriage in those who already had it; the second split is between antiseptics and antibiotics; and the third split is between those that included patients having the catheter inserted before dialysis started and people already on dialysis. Many of the trials were small or short-term. The quality was often not good by today-s standards. The body of evidence suggested a reduction in exit-site infections but this did not seem to lead to a significant reduction in peritonitis, although to some extent this reflected insufficient power in the studies and a low incidence of peritonitis in them.
Authors' recommendations:
The importance of peritonitis is not in doubt. It is the main cause of people having to switch from peritoneal dialysis to haemodialysis, which leads to reduced quality of life for patients and increased costs to the NHS. Unfortunately, the present evidence base for the prevention of peritonitis is disappointing; it suggests that the interventions reduce exit-site infections but not peritonitis, although this may be due to trials being in too small numbers for too short periods.
Authors' methods:
Review
Details
Project Status:
Completed
URL for project:
http://www.hta.ac.uk/1498
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Hospitals
- Cross Infection
- Staphylococcal Infections
- Staphylococcus aureus
- Surgical Wound Infection
Contact
Organisation Name:
NIHR Health Technology Assessment programme
Contact Address:
NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
journals.library@nihr.ac.uk
Contact Email:
journals.library@nihr.ac.uk
Copyright:
2009 Queen's Printer and Controller of HMSO
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