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Rapid De-escalation of Anti-MRSA Therapy Guided by S. Aureus Nares Screening in Case of Pneumonia

RecruitingNAAges 18 Years - anyAllUniversity of Bari Aldo Moro
NCT06238297 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

The current IDSA/ATS guidelines recommend Linezolid and Vancomycin for MRSA coverage in hospitalized patients with pneumonia, which is common clinical practice in Italy. However, a nasal PCR-assay for MRSA has a high negative predictive value and can facilitate rapid antibiotic de-escalation, thereby avoiding unnecessary anti-MRSA treatments. The indiscriminate use of these drugs has contributed to the emergence of resistant S. aureus strains and has led to significant adverse effects, without providing any survival benefits. Additionally, it has increased hospital stays and associated costs. The proposed study aims to use this diagnostic tool to shorten empirical anti-MRSA treatment duration in pneumonia patients, focusing on reducing antimicrobial therapy days while measuring in-hospital mortality, length of stay and adverse drug event incidence.

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📋 Eligibility rules (as published)
Inclusion Criteria: * Subjects 18 years or older. * Patients hospitalized at the Azienda Consorziale Policlinico di Bari; * Clinical diagnosis of CAP/HAP/VAP; * Commitment by the prescribing physician to set an anti-MRSA antibiotic therapy in empirical * Enrollement within 48h from the beginning of the empirical anti-MRSA therapy. Exclusion Criteria: * Febrile neutropenia or severe immunodeficiency; * Chronic airway infection (eg cystic fibrosis); * Suspect of extrapulmonary infection by MRSA * Refusal by the patient or legal guardian; * Refusal by the physician in charge of the patient to perform antibiotic de-escalation based on the result of the nasal swab; * Enrollment after 48 hours from the beginning of the empirical anti-MRSA therapy.
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What it tests

  • MRSA nasal swab based de-escalation
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Where

1 site
Università di Bari "Aldo Moro"
Bari, Italy
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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