Dicloxacillin: a higher risk than cloxacillin for infusion phlebitis.
Ever since dicloxacillin and cloxacillin were introduced in the 1960s, it has been known that they are associated with a high incidence of infusion phlebitis. Some in vitro studies and clinical experience have indicated that dicloxacillin is the more vessel-irritating of the 2 drugs. In this prospective observational study on 39 patients with 111 peripheral venous catheters (PVCs), the incidence of infusion phlebitis was compared between these 2 drugs. The incidence of phlebitis was 38% with dicloxacillin and 21% with cloxacillin; which, compared by logistic regression with other risk factors as covariates, was significant [odds ratio 5.06, 95% confidence interval (95% CI) 1.45-17.60]. Since the duration of catheterization is also an important risk factor, Cox regression was performed, and the difference between the 2 drugs was still significant (proportional hazard rate 3.48, 95%, CI 1.64-7.38). The only other significant risk factor found in the study was the insertion site; the risk was higher in PVCs inserted in the forearm/antecubital fossa than in the hand/wrist. The infusion time and dilution of the infusate were not significant risk factors.
Lanbeck
Peter
P
Department of Infectious Diseases, Lund University, Malmö University Hospital, Malmö, Sweden. Peter.Lanbeck@inf.mas.lu.se
Odenholt
Inga
I
Paulsen
Otto
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003023:Cloxacillin / Q000009:adverse effects*; D004009:Dicloxacillin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000009:adverse effects*; D010689:Phlebitis / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors
D010406:Penicillins; D004009:Dicloxacillin; D003023:Cloxacillin