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Prevention of Nosocomial Infection by Decontamination of the Naso- and Oropharynx With Chlorhexidine (NONI Trial)
This study has been completed.
Sponsors and Collaborators: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Dept of cardiothoracic surgery Academic Medical Center
Dept of cardiothoracic surgery Onze Lieve Vrouwe Gasthuis Amsterdam
Information provided by: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
ClinicalTrials.gov Identifier: NCT00272675
  Purpose

Does chlorhexidine gluonate, a simple broad-spectrum antimicrobial agent with virtually no adverse-effects lower the incidence of NI after cardiac surgery, especially with respect to LTI and SSI?


Condition Intervention Phase
Nosocomial Infection
Respiratory Tract Infection
Surgical Site Infection
Drug: Chlorhexidine gluconate (drug) vs placebo
Phase II
Phase III

MedlinePlus related topics: Heart Surgery
Drug Information available for: Chlorhexidine Chlorhexidine digluconate D-Gluconic acid, monosodium salt Gluconic acid Manganese gluconate
U.S. FDA Resources
Study Type: Interventional
Study Design: Prevention, Randomized, Double-Blind, Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: Prevention of Nosocomial Infection in Cardiac Surgery by Decontamination of the Naso- and Oropharynx With Chlorhexidine. A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Further study details as provided by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA):

Primary Outcome Measures:
  • Nosocomial Infection

Secondary Outcome Measures:
  • Respiratory tract and surgical site infection; S. aureus nasal carriage, nonprophylactic antibiotic use, hospital stay, in-hospital mortality, optimal duration of preoperative trial medication and medication adverse-effects.

Estimated Enrollment: 1000
Study Start Date: August 2003
Estimated Study Completion Date: September 2005
Detailed Description:

Nosocomial infections (NIs) after open heart surgery are recognized as an important cause of morbidity and mortality with a prolonged hospital stay, increased need for of antibiotics, decreased quality of life and higher concomitant costs. Decontamination of the oropharynx seems important, since there is direct evidence of an association between pulmonary infection and oral health. Another important strategy involves the eradication of Staphylococcus aureus, the most important pathogen causing SSI. The most common reservoir of S.aureus is the anterior nares and eradication can be achieved by the application of topical antibiotics. Although promising results have been reported for both strategies, they are not widely used as routine prevention methods because of the variability of trial design, the concern about the emergence of antimicrobial resistance and increased costs. Further research is essential to evaluate different protocols, antimicrobial agents and cost-effectiveness.

Fur this purpose, we designed a clinical trial to study wether a simple broad-spectrum antimicrobial agent with virtually no adverse-effects would lower the incidence of NI after cardiac surgery, especially with respect to LTI and SSI.

Comparison(s): Oropharyngeal and nasal decontamination with chlorhexidine compared to placebo in patients after cardiothoracic surgery

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • all adult patients (above 18) who were scheduled to undergo sternotomy for cardiothoracic surgery

Exclusion Criteria:

  • emergency procedures, a preoperative infection and/or the use of antibiotics, hypersensitivity to chlorhexidine gluconate (CHX), absence of written informed consent or presence of an alternative prophylactic regimen like selective decontamination of the digestive tract
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00272675

Locations
Netherlands
Onze lieve vrouwe gasthuis
Amsterdam, Netherlands, 1090 HM
Sponsors and Collaborators
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Dept of cardiothoracic surgery Academic Medical Center
Dept of cardiothoracic surgery Onze Lieve Vrouwe Gasthuis Amsterdam
Investigators
Principal Investigator: Patrique Segers, Drs. Academic Medical Center Amsterdam
  More Information

Publications indexed to this study:
Study ID Numbers: WO-03.021
Study First Received: January 4, 2006
Last Updated: January 6, 2006
ClinicalTrials.gov Identifier: NCT00272675  
Health Authority: Netherlands: Medical Ethics Review Committee (METC)

Keywords provided by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA):
Nosocomial infection,
Decontamination,
Randomized placebo-controlled trial,
Cardiac surgery,
Chlorhexidine,
Prevention

Study placed in the following topic categories:
Chlorhexidine
Respiratory Tract Diseases
Respiratory Tract Infections
Chlorhexidine gluconate
Cross Infection

Additional relevant MeSH terms:
Anti-Infective Agents
Anti-Infective Agents, Local
Communicable Diseases
Disinfectants
Therapeutic Uses
Infection
Dermatologic Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009