title: Ethanol-lock technique in the treatment of bloodstream infections in pediatric oncology patients with broviac catheter.
abstract: OBJECTIVE
  To assess the ethanol-lock technique as a means of treating central venous line infections. Bloodstream infections in patients with tunneled central venous catheters can lead to removal of the lines.
  
  
  METHODS
  Twenty-eight children and adolescents aged 2 to 18 years, with different types of cancer, had Broviac catheters and presented with positive blood culture and clinical signs of infection between January 2000 and December 2001. The ethanol-lock technique was performed 24 times in 18 patients in addition to empiric (initially) and specific (after antibiogram) intravenous antibiotic treatment. In another 15 cases, 13 children were treated with systemic antibiotics alone.
  
  
  RESULTS
  Sixty-seven percent of the patients treated with ethanol locks had no infectious relapse of any kind within 4 weeks of treatment or during subsequent aplasia, compared with 47% treated with systemic antibiotics alone. In one boy the catheter infection could not be cleared with systemic antibiotics alone, but after one course of ethanol locks no more blood culture-positive infectious episodes were observed. No severe clinical side effects of ethanol flush were observed. Mild symptoms that occurred were tiredness, headaches, dizziness, nausea, and light-headedness.
  
  
  CONCLUSIONS
  The ethanol-lock technique appears to be a safe, well tolerated, and effective way to treat central venous line infections, even in small children. A prospective randomized study should be designed to compare antibiotic-lock, ethanol-lock technique, and systemic antibiotics alone in the treatment of device-associated bloodstream infection.
authors.affiliation: Department of Pediatric Hematology and Oncology, Leipzig University Children's Hospital, Leipzig, Germany. cdannenberg@web.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Dannenberg
authors.forename: Uta
authors.initials: U
authors.lastname: Bierbach
authors.forename: Antje
authors.initials: A
authors.lastname: Rothe
authors.forename: Jörg
authors.initials: J
authors.lastname: Beer
authors.forename: Dieter
authors.initials: D
authors.lastname: Körholz
mesh_terms: D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000494:pharmacology*; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology*; D002404:Catheterization; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005334:Fever / Q000150:complications / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications / Q000209:etiology; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol