Antibiotic-coated hemodialysis catheters for the prevention of vascular catheter-related infections: a prospective, randomized study.
OBJECTIVE
To determine the efficacy of minocycline-rifampin-coated hemodialysis catheters in reducing catheter-related infections in patients requiring hemodialysis for acute renal failure.


METHODS
Between May 2000 and March 2002, 66 patients were randomly assigned to receive a minocycline-rifampin-impregnated central venous catheter and 64 were randomly assigned to receive an unimpregnated catheter. Patients were followed prospectively until the catheter was removed. Catheter-related infection was determined through quantitative catheter cultures, quantitative blood cultures, or both.


RESULTS
Both groups of patients were similar in age, sex, underlying disease, type of dialysis (continuous vs. intermittent), neutropenia during catheterization and its duration, catheter insertion difficulties, and administration of blood products or medication. The mean (+/- SD) catheter dwell time was the same in both groups (8 +/- 6 days, P = 0.7). There were seven catheter-related infections (11%), all associated with the use of unimpregnated catheters. Kaplan-Meier estimates for the risk of catheter-related infection showed that coated catheters were less likely to be associated with infection (P = 0.006).


CONCLUSIONS
The use of polyurethane hemodialysis catheters impregnated with minocycline and rifampin decreases the risk of catheter-related infection in patients with acute renal failure.
Chatzinikolaou
Ioannis
I
University of Texas M. D. Anderson Cancer Center,Houston, Texas 77030, USA.
Finkel
Kevin
K
Hanna
Hend
H
Boktour
Maha
M
Foringer
John
J
Ho
Tam
T
Raad
Issam
I
D058186:Acute Kidney Injury / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage* / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D004359:Drug Therapy, Combination / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage* / Q000627:therapeutic use; D011140:Polyurethanes; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*; D012293:Rifampin / Q000008:administration & dosage* / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects; D013212:Staphylococcus epidermidis; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D011140:Polyurethanes; D008911:Minocycline; D012293:Rifampin