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

Recruiting now · Not applicable

Conditions studied: Pneumonia, Bacterial

In brief

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.

Key facts

Study ID

NCT06238297

Run by

University of Bari Aldo Moro

People needed

76

Starts

2024-05-06

Expected to finish

2025-06-30

Last updated by the study team

2025-05-30

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• 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.

You may not qualify if…

• 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.

Where it is running

• Università di Bari "Aldo Moro" — Bari, Italy (enrolling)

Full record on ClinicalTrials.gov

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