In Reply Dr Kressel raises several important points in response to our Viewpoint, which we believe reinforce the major arguments from the article.
First, as Kressel points out and as acknowledged in our Viewpoint, the evidence to support CPs is not strong. Although the BUGG trial1 failed to show a difference in the primary composite outcome of acquisition of MRSA or VRE, the secondary analysis, which was planned a priori, revealed a lower risk of acquisition of MRSA (but not VRE), and had no effect on rates of adverse events and improving room-exit hand hygiene compliance. These mixed results failed to clarify the issue, but nevertheless provided some evidence in support of CPs for endemic MRSA.
Rubin MA, Samore MH, Harris AD. Contact Precautions to Prevent Pathogen Transmission—Reply. JAMA. 2018;320(4):407–408. doi:10.1001/jama.2018.6986
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