MRSA Decolonization in Complicated Carriage

NCT ID: NCT05268120

Last Updated: 2025-03-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

211 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-25

Study Completion Date

2028-05-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Multicenter open-label cluster randomized controlled trial determining the superiority of doxycycline-rifampicin compared to trimethoprim-rifampicin for the decolonization treatment of complicated MRSA carriership.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Rationale: MRSA decolonization has proven to prevent infection and reduce transmission. It has yet remained undecided which combination of anti-staphylococcal agents is most effective in the treatment of complicated MRSA carriage. A recent cohort study showed the highest success rate of decolonization in patients treated with doxycycline-rifampicin (86%) compared to the other antibiotic combinations (average 69%). However, because of the retrospective study design the validity of the results is limited. A randomized clinical study is necessary to determine if doxycycline-rifampicin is superior to other conventional treatment regimens. The Dutch guideline recommends both doxycycline-rifampicin and trimethoprim-rifampicin as first choice treatments for decolonization of complicated MRSA carriage. Therefore trimethoprim-rifampicin will be the comparator of this study.

Objective: To determine the superiority of doxycycline-rifampicin compared to trimethoprim-rifampicin for the decolonization treatment of complicated MRSA carriership.

Study design: Multicenter open-label cluster randomized controlled trial.

Study population: Adult (\>18 years) patients with complicated MRSA carriership, treated at one of the participating outpatient clinics. Sample size 211 patients.

Intervention: Group A: doxycycline 200 mg q.d. - rifampicin 600mg b.i.d. versus Group B: trimethoprim 200mg b.i.d. - rifampicin 600mg b.i.d. All orally, total duration 7 days.

Main study parameters/endpoints: The main study endpoint is the success rate of MRSA decolonization. Successful decolonization is defined as 3 consecutive negative cultures after treatment, with a minimum interval of 7 days.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: MRSA decolonization treatment is already standard clinical practice in the Netherlands. There is no additional burden or risk associated with participation in the study. Both antibiotic regimens (in Group A and Group B) used in the study, are recommended as first-line therapy by the Dutch guideline for the treatment of MRSA carriage. The study is open label, so there is no additional risk of blinding. The number of outpatient visits and follow-up cultures are not different from daily clinical practice in the Netherlands. No invasive procedures will be performed for the purpose of this study.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

MRSA

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

A

doxycycline 200 mg q.d. - rifampicin 600mg b.i.d.

Group Type ACTIVE_COMPARATOR

doxycycline 200 mg q.d. - rifampicin 600mg b.i.d.

Intervention Type DRUG

Both first choice treatments in Dutch guideline for MRSA decolonization

B

trimethoprim 200mg b.i.d. - rifampicin 600mg b.i.d.

Group Type ACTIVE_COMPARATOR

trimethoprim 200mg b.i.d. - rifampicin 600mg b.i.d.

Intervention Type DRUG

Both first choice treatments in Dutch guideline for MRSA decolonization

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

doxycycline 200 mg q.d. - rifampicin 600mg b.i.d.

Both first choice treatments in Dutch guideline for MRSA decolonization

Intervention Type DRUG

trimethoprim 200mg b.i.d. - rifampicin 600mg b.i.d.

Both first choice treatments in Dutch guideline for MRSA decolonization

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age ≥18 years
* Complicated MRSA carriership. Complicated carriership is defined as having one of the following features: (i) the presence of MRSA located at another site than the nose, (ii) an active infection with MRSA, (iii) in vitro resistance for mupirocin, (iv) active skin lesions, (v) foreign material that connects an internal body site with the outside (e.g., urine catheter, external fixation material), (vi) previously failure of decolonization treatment.

In case of none of the previously mentioned features, this is considered uncomplicated carriership.

\- The ability to provide informed consent for the use of their data.

Exclusion Criteria

* \- Presence of any iv-access, urinary catheters or drains (because of high risk of treatment failure)
* Failure of previous decolonization attempt of complicated MRSA carriage
* Allergy or other contra-indication to either doxycycline, rifampicin or trimethoprim (these patients will participate in the observational arm)
* Previous participation in this study (every patient can only participate once)
* Pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Leiden University Medical Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

acwestgeest

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Merel Lambregts, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Leiden University Medical Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

LUMC

Leiden, , Netherlands

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Netherlands

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Annette Westgeest, MD

Role: CONTACT

+3171 5262613

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Merel Lambregts

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

NL79720.058.21

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Rickettsia Clearance Study
NCT05972772 RECRUITING PHASE2/PHASE3