title: Peripheral intravenous line survival and phlebitis prevention in patients receiving intravenous antibiotics: heparin/hydrocortisone versus in-line filters.
abstract: OBJECTIVE
  To compare the use of in-line filtration with the addition of heparin/hydrocortisone (hep/hc) to the infusate for both phlebitis prevention and intravenous (i.v.) line survival in peripheral i.v. catheters. This study was specific for a patient group receiving prolonged courses of i.v. antibiotics. Analysis of the two endpoints for conventional short i.v. catheters (short lines) versus long (30 cm) i.v. catheters (long lines) was also performed.
  
  
  METHODS
  Patients with cystic fibrosis receiving intermittent i.v. antibiotics were randomly allocated to receive their drugs either through an in-line filter using a drug-free infusate or with no filter and an infusate containing heparin 500 units and hydrocortisone 10 mg/L. Infusion sites were assessed daily.
  
  
  RESULTS
  Both the hep/hc and filter groups were similar in terms of phlebitis incidence and i.v. line survival when analyzed separately for both short and long lines. Long lines displayed markedly prolonged survival times and reduced phlebitis compared with short lines.
  
  
  CONCLUSIONS
  The effectiveness of i.v. filters in excluding the large particle load introduced by i.v. antibiotics and hence in reducing the subsequent phlebitis makes them a useful alternative to the use of hep/hc. The use of filters in this patient group may offer advantages in terms of ease of use and a possible decrease in hep/hc-related problems. Long lines offer practical advantages over short lines for patients requiring longer term i.v. access.
authors.affiliation: Pharmacy Department, Women's and Children's Hospital, North Adelaide, Australia.
authors.forename: G W
authors.initials: GW
authors.lastname: Roberts
authors.forename: M D
authors.initials: MD
authors.lastname: Holmes
authors.forename: R E
authors.initials: RE
authors.lastname: Staugas
authors.forename: R A
authors.initials: RA
authors.lastname: Day
authors.forename: C F
authors.initials: CF
authors.lastname: Finlay
authors.forename: A
authors.initials: A
authors.lastname: Pitcher
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications; D005260:Female; D005374:Filtration; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D010689:Phlebitis / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D006493:Heparin; D006854:Hydrocortisone