Inpharma 1499 - 6 Aug 2005

Vancomycin: MRSA control duringmechanical ventilation

Vancomycin 4% oropharyngeal gel significantlyreduces meticillin-resistant Staphylococcus aureus(MRSA) carriage and subsequent infection comparedwith vancomycin 2% gel in patients undergoingmechanical ventilation, according to investigators fromItaly.

A total of 265 patients were eligible for this sequentialstudy, including 125 who were positive for MRSA.Surveillance swabs of throat and rectum were taken atbaseline and then twice weekly. Patients with culturespositive for MRSA received enteral vancomycin 1 g/daygiven four times daily. In addition, patients enrolled inthe first year received vancomycin 2% gel (80mg;Group A), while those enrolled in the second yearreceived vancomycin 4% gel (160mg; Group B), appliedto the oropharnyx in four doses.

The absolute carriage of MRSA was 3.6 for Group Aand 3.2 for Group B. The vancomycin 4% protocolreduced absolute carriage to 1.5 versus 2.6 with thevancomycin 2% protocol (p < 0.01). Secondaryendogenous infection episodes were significantlyreduced in patients treated with vancomycin 4% gelcompared with vancomycin 2% gel (7 vs 15 episodes).

Among 3588 microbiological samples tested, no S.aureus with intermediate sensitivity to vancomycin orvancomycin-resistant enterococci were isolated.Viviani M, et al. Control of imported and acquired methicillin-resistantstaphylococcus aureau in mechanically ventilated patients: a dose-response studyof enteral vancomycin to reduce absolute carriage and infection. Anaesthesia andIntensive Care 33: 361-372, No. 3, Jun 2005 800994920

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Inpharma 6 Aug 2005 No. 14991173-8324/10/1499-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved