Prophylaxis against dialysis catheter-related bacteremia with a novel antimicrobial lock solution.
Catheter-related bacteremia, a frequent complication in patients who are undergoing hemodialysis, may be prevented by eradication of the catheter biofilm. Catheter lock solution (CLS) is an investigational preparation containing taurolidine, a biocompatible antimicrobial agent, and citrate, an anticoagulant agent. CLS was instilled into the catheter lumens after each dialysis session for 20 catheter-dependent hemodialysis patients. Catheter outcomes were compared with those observed in 30 concurrent control patients whose catheters were instilled with heparin. Bacteremia-free survival at 90 days was higher among patients who received CLS than among control patients who received heparin (94% vs. 47%; P<.001). Unassisted catheter patency (without tissue plasminogen activator instillation) was lower among patients who received CLS than among control patients (32% vs. 76%; P<.001). CLS dramatically reduces the frequency of catheter-related bacteremia among patients undergoing hemodialysis, although there is an increased requirement for thrombolytic interventions to maintain catheter patency.
Allon
Michael
M
Division of Nephrology, University of Alabama at Birmingham, USA. mdallon@uab.edu
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000401:mortality / Q000517:prevention & control*; D002404:Catheterization / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D013829:Thiadiazines / Q000627:therapeutic use*
D000890:Anti-Infective Agents; D013829:Thiadiazines; D013654:Taurine; C012566:taurolidine