A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections.
OBJECTIVE
To test the efficacy of the ARROWgard (Arrow International Inc, Reading, Pa) central venous catheter (CVC) coated with silver sulfadiazine and chlorhexidine (A-CVC) in the prevention of CVC-related infections.


METHODS
Prospective, randomized trial.


METHODS
A tertiary care medical center.


METHODS
Two hundred eighty-two patients who required CVC placement were evaluated in this study. Patients were prospectively randomized to receive either a standard CVC (S-CVC) or the A-CVC. Only fresh-stick double- and triple-lumen catheters were studied.


METHODS
Patients were evaluated for catheter site inflammation, catheter site colonization, local catheter-related infection, and catheter-related septicemia.


RESULTS
The 2 groups were matched for age, percentage in the intensive care unit, percentage receiving total parenteral nutrition, percentage with triple-lumen catheters, and duration of catheterization. Rates of catheter site inflammation in the 2 groups were similar (12% vs 10%, S-CVC group and A-CVC group, respectively). The A-CVC was associated with a significantly decreased catheter site colonization rate (49% vs 28%; 43% reduction; P<.001) and local catheter-related infection rate (22.4% vs 5.8%; 74% reduction; P<.001). Rates of catheter-related septicemia were reduced by 41% in the A-CVC group (6.4% vs 3.8%, S-CVC group and A-CVC group, respectively), but this was not statistically significant.


CONCLUSIONS
Despite a marked decrease in catheter site colonization and catheter-related infection rates, the A-CVC did not significantly reduce the incidence of catheter-related septicemia. This may be due to a greater pathogenic dependence on catheter hub contamination rather than catheter site colonization or local catheter-related infection, or the relatively short (5.2 days) duration of catheterization in this study.
Tennenberg
S
S
Department of Surgery, Detroit Veterans Affairs Medical Center, Wayne State University School of Medicine, Mich 48201-1932, USA.
Lieser
M
M
McCurdy
B
B
Boomer
G
G
Howington
E
E
Newman
C
C
Wolf
I
I
D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000517:prevention & control*; D012837:Silver Sulfadiazine / Q000008:administration & dosage / Q000627:therapeutic use*
D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine; D012837:Silver Sulfadiazine