Mupirocin 2% Ointment Vs Spray Antibiotics on Temporary Hemodialysis Catheter
Condition: Hemodialysis Complication; Hemodialysis Catheter Infection
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      In dialysis centers, many patients are undergoing hemodialysis simultaneously, which
      facilitates the spread of microorganisms by direct or indirect contact through the devices,
      equipment, surface contact, and hands of health profession Over time, catheters are prone to
      higher rates of infection, thrombosis, and central venous stenosis, it has also been shown
      that catheters are an independent (of infection) inflammatory stressor and lead to increased
      morbidity .

      Catheters are aptly referred to as a bacterial highway, and a biofilm formation around the
      catheter is often the breeding ground of bacteria and fungi, which can easily spread to the
      bloodstream Infectious complications are the most serious with regards to patient morbidity
      and mortality. The incidence could be from 3.8 to5.5 episodes per 1000 days

      Migration of micro-organism along the external surface of the catheter is probably the most
      common route of infection through skin and represents 58% .HD catheter has biofilm formation
      on their surfaces and this serves as a good reservoir for micro-organisms

      Most patients with end stage renal disease (ESRD) starting hemodialysis through hemodialysis
      catheter about 9 % in Egypt and most of them require several hemodialysis catheters before
      maturation of arterio -venous fistula and even after stopping it.
    

Detailed description: 
      Patients receiving hemodialysis have a high risk of infection due to the immunosuppressive
      effects caused by ESRD, comorbidities, inadequate nutrition and the need for maintenance of
      vascular access for long periods.

      The catheters are rightfully the least preferred modality and, in an ideal setting, no
      patient should have a catheter as access. Despite the perils associated with dialysis
      catheters, their use has increased to almost 70% incident dialysis initiation with catheters
      In dialysis centers, many patients are undergoing hemodialysis simultaneously, which
      facilitates the spread of microorganisms by direct or indirect contact through the devices,
      equipment, surface contact, and hands of health profession Over time, catheters are prone to
      higher rates of infection, thrombosis, and central venous stenosis, it has also been shown
      that catheters are an independent (of infection) inflammatory stressor and lead to increased
      morbidity Catheters are aptly referred to as a bacterial highway, and a biofilm formation
      around the catheter is often the breeding ground of bacteria and fungi, which can easily
      spread to the bloodstream Infectious complications are the most serious with regards to
      patient morbidity and mortality. The incidence could be from 3.8 to5.5 episodes per 1000 days

      Migration of micro-organism along the external surface of the catheter is probably the most
      common route of infection through skin and represents 58% .HD catheter has biofilm formation
      on their surfaces and this serves as a good reservoir for micro-organisms

      Most patients with end stage renal disease (ESRD) starting hemodialysis through hemodialysis
      catheter about 9 % in Egypt and most of them require several hemodialysis catheters before
      maturation of arterio -venous fistula and even after stopping it.
    

Intervention name(s): Local antibiotic spray Neomycin sulphate 165,000 IU + Bacitracin zinc 12,500 IU; Mupirocin 2% ointment
Intervention type(s): Drug; Drug
Intervention description(s): The intervention Sprayed 1 to 3 times /day; 10 mm of mupirocin ointment squeezed directly on to their exit sites from a 15 g tube with an outlet diameter of 5 mm
Other intervention name(s): BIVATRACIN
Intervention MeSH terms: Anti-Bacterial Agents; Mupirocin; Neomycin; Bacitracin
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention