NCT03586362

Vancomycin De-escalation Therapy in Patients With Pneumonia

Vancomycin De-escalation Therapy in Patients With Pneumonia and Negative MRSA Nasal Swab

• Status: Unknown
• Phase: —
• Study type: Observational
• Enrollment: 278 (estimated)
• Sponsor: CAMC Health System · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This is a non-inferiority study evaluating clinical improvement rate when using MRSA nasal swabs to guide discontinuation of vancomycin for empiric coverage for MRSA pneumonia.

Detailed description

Current clinical guidelines recommend including vancomycin in initial empiric therapy if risk factors for MRSA infection are present, or there is a high incidence of MRSA locally. Prolonged exposure to vancomycin, however, has been linked with the risk of vancomycin-associated kidney failure. Studies have reported that a MRSA nasal swab may be used to predict the presence of MRSA pneumonia. Specifically, pneumonia patients with negative MRSA nasal swabs are 95-99% likely to not have pneumonia due to MRSA. There is limited data, however, evaluating the use of a MRSA nasal swab to guide vancomycin therapy. Accordingly, in this study, pneumonia patients in the intervention arm will have empiric vancomycin discontinued following a negative MRSA nasal swab. In the control arm, patients vancomycin will not be discontinued based on the MRSA nasal swab result. The rate of clinical resolution will be compared between these two study arms.

Conditions

• Pneumonia

Timeline

• Start date: 2018-02-08
• Primary completion: 2023-06-30
• Completion: 2023-12-30
• First posted: 2018-07-13
• Last updated: 2022-07-20

Locations

1 site across 1 country: United States