Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus Mupirocin for the prevention of catheter-associated infections in hemodialysis patients

Johnson, David Wayne, van Eps, Carolyn, Mudge, David William, Wiggins, Kathryn Joan, Armstrong, Kirsty, Hawley, Carmel Mary, Campbell, Scott Bryan, Isbel, Nicole Maree, Nimmo, Graeme Robert and Gibbs, Harry (2005) Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus Mupirocin for the prevention of catheter-associated infections in hemodialysis patients. Journal of The American Society of Nephrology, 16 5: 1456-1462. doi:10.1681/ASN.2004110997


Author Johnson, David Wayne
van Eps, Carolyn
Mudge, David William
Wiggins, Kathryn Joan
Armstrong, Kirsty
Hawley, Carmel Mary
Campbell, Scott Bryan
Isbel, Nicole Maree
Nimmo, Graeme Robert
Gibbs, Harry
Title Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus Mupirocin for the prevention of catheter-associated infections in hemodialysis patients
Journal name Journal of The American Society of Nephrology   Check publisher's open access policy
ISSN 1046-6673
1533-3450
Publication date 2005
Sub-type Article (original research)
DOI 10.1681/ASN.2004110997
Volume 16
Issue 5
Start page 1456
End page 1462
Total pages 7
Editor W. G. Couser
Place of publication Washington, DC, United States
Publisher Lippincott Williams and Wilkins
Collection year 2005
Language eng
Subject C1
321012 Nephrology and Urology
730118 Organs, diseases and abnormal conditions not elsewhere classified
Abstract The clinical usefulness of hemodialysis catheters is limited by increased infectious morbidity and mortality. Topical antiseptic agents, such as mupirocin, are effective at reducing this risk but have been reported to select for antibiotic-resistant strains. The aim of the present study was to determine the efficacy and the safety of exit-site application of a standardized antibacterial honey versus mupirocin in preventing catheter-associated infections. A randomized, controlled trial was performed comparing the effect of thrice-weekly exit-site application of Medihoney versus mupirocin on infection rates in patients who were receiving hemodialysis via tunneled, cuffed central venous catheters. A total of 101 patients were enrolled. The incidences of catheter-associated bacteremias in honey-treated (n = 51) and mupirocin-treated (n = 50) patients were comparable (0.97 versus 0.85 episodes per 1000 catheter-days, respectively; NS). On Cox proportional hazards model analysis, the use of honey was not significantly associated with bacteremia-free survival (unadjusted hazard ratio, 0.94; 95% confidence interval, 0.27 to 3.24; P = 0.92). No exit-site infections occurred. During the study period, 2% of staphylococcal isolates within the hospital were mupirocin resistant. Thrice-weekly application of standardized antibacterial honey to hemodialysis catheter exit sites was safe, cheap, and effective and resulted in a comparable rate of catheter-associated infection to that obtained with mupirocin (although the study was not adequately powered to assess therapeutic equivalence). The effectiveness of honey against antibiotic-resistant microorganisms and its low likelihood of selecting for further resistant strains suggest that this agent may represent a satisfactory alternative means of chemoprophylaxis in patients with central venous catheters.
Keyword Urology & Nephrology
Resistant Staphylococcus-aureus
Chronic Peritoneal-dialysis
Central Venous Catheter
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
 
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