The large multi-center ICU trial randomized ICUs to 1 of 3 strategies: MRSA screening/isolation, MRSA screening/isolation/decolonization, or global decolonization (5 days BID nasal mupiricin and daily chlorhexidine bathing). The hazard ratios for MRSA isolates in the 3 groups were 0.92, 0.75, 0.63 respectively. The hazard ratios for any bloodstream infection in the 3 groups were 0.99, 0.78, and 0.56 respectively. Global decolonization of ICU patients results in lower MRSA acquisition and bloodstream infections compared to targeted decolonization based on screening (abstract).
Traditionally, researchers run clinical trials (RCTs) in three steps: They formulate the trial. They conduct the trial via a preconceived design. They analyze the data according to a pre-specified plan. When you have only a few bucks, little time to spare, and billions of dollars on the line, what might you do to economize the […]
The kids are navigating the crisis with maturity and aplomb and way too much “Clash Royale.” Online school somehow went through the wash and has shrunk to 3 hours, including lunch. They continue to seek ways to fill up the day. We’ve tried to set some clear goals, pulled out the QI toolkit and made […]
“…such disparities, which are biological in their expression but are largely socially determined” – Paul Farmer, MD I read this quote, and now more than ever, I find that it resonates with me in a new way. I am a nocturnist at a community hospital in one of the most diverse cities in our country, […]