title: Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. The Texas Medical Center Catheter Study Group.
abstract: BACKGROUND
  Central venous catheters are a principal source of nosocomial bloodstream infections, which are difficult to control.
  
  
  OBJECTIVE
  To determine the efficacy of catheters coated with minocycline and rifampin in preventing catheter-related colonization and bloodstream infections.
  
  
  METHODS
  Multicenter, randomized clinical trial.
  
  
  METHODS
  Five university-based medical centers.
  
  
  METHODS
  281 hospitalized patients who required 298 triple-lumen, polyurethane venous catheters.
  
  
  METHODS
  147 catheters were pretreated with tridodecylmethyl-ammonium chloride and coated with minocycline and rifampin. Untreated, uncoated catheters (n = 151) were used as controls.
  
  
  METHODS
  Quantitative catheter cultures, blood cultures, and molecular typing of organisms to determine catheter-related colonization and bloodstream infections.
  
  
  RESULTS
  The group with coated catheters and the group with uncoated catheters were similar with respect to age, sex, underlying diseases, degree of immunosuppression, therapeutic interventions, and risk factors for catheter infections. Colonization occurred in 36 (26%) uncoated catheters and 11 (8%) coated catheters (P < 0.001). Catheter-related bloodstream infection developed in 7 patients (5%) with uncoated catheters and no patients with coated catheters (P < 0.01). Multivariate logistic regression analysis showed that coating catheters with minocycline and rifampin was an independent protective factor against catheter-related colonization (P < 0.05). No adverse effects related to the coated catheters or antimicrobial resistance were seen. An estimate showed that the use of coated catheters could save costs.
  
  
  CONCLUSIONS
  Central venous catheters coated with minocycline and rifampin can significantly reduce the risk for catheter-related colonization and bloodstream infections. The use of these catheters may save costs.
authors.affiliation: University of Texas M.D. Anderson Cancer Center, Houston, USA.
authors.forename: I
authors.initials: I
authors.lastname: Raad
authors.forename: R
authors.initials: R
authors.lastname: Darouiche
authors.forename: J
authors.initials: J
authors.lastname: Dupuis
authors.forename: D
authors.initials: D
authors.lastname: Abi-Said
authors.forename: A
authors.initials: A
authors.lastname: Gabrielli
authors.forename: R
authors.initials: R
authors.lastname: Hachem
authors.forename: M
authors.initials: M
authors.lastname: Wall
authors.forename: R
authors.initials: R
authors.lastname: Harris
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: A
authors.initials: A
authors.lastname: Buzaid
authors.forename: C
authors.initials: C
authors.lastname: Robertson
authors.forename: S
authors.initials: S
authors.lastname: Shenaq
authors.forename: P
authors.initials: P
authors.lastname: Curling
authors.forename: T
authors.initials: T
authors.lastname: Burke
authors.forename: C
authors.initials: C
authors.lastname: Ericsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D000904:Antibiotics, Antitubercular / Q000191:economics / Q000627:therapeutic use*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000191:economics; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000191:economics / Q000382:microbiology; D003362:Cost-Benefit Analysis; D004269:DNA, Bacterial / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D004311:Double-Blind Method; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000191:economics / Q000627:therapeutic use*; D012293:Rifampin / Q000191:economics / Q000627:therapeutic use*; D012306:Risk; D018805:Sepsis / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D004269:DNA, Bacterial; D004279:DNA, Viral; D008911:Minocycline; D012293:Rifampin