Long-term silicone central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: a prospective randomized clinical trial.
OBJECTIVE
To evaluate the efficacy of long-term nontunneled silicone catheters impregnated with minocycline and rifampin (M-R) in reducing catheter-related bloodstream infections.


METHODS
This prospective, randomized, double-blind clinical trial was conducted at M.D. Anderson Cancer Center, a tertiary care hospital in Houston, TX. All patients in the trial had a malignancy.


RESULTS
Between September 1999 and May 2002, 356 assessable catheters were used: 182 M-R and 174 nonimpregnated. The patients' characteristics were comparable between the two study groups. The mean (+/- standard deviation) duration of catheterization with M-R catheters was comparable to that of nonimpregnated catheters (66.21 +/- 30.88 v 63.01 +/- 30.80 days). A total of 17 catheter-related bloodstream infections occurred during the course of the study. Three were associated with the use of M-R catheters and 14 were associated with the nonimpregnated catheters, with a rate of catheter-related bloodstream infection of 0.25 and 1.28/1,000 catheter-days, respectively (P = .003). Gram-positive cocci accounted for the majority of the organisms causing the infections. There were no allergic reactions associated with M-R catheters.


CONCLUSIONS
Long-term nontunneled central venous catheters impregnated with minocycline and rifampin are efficacious and safe in reducing catheter-related bloodstream infections in cancer patients.
The University of Texas M.D. Anderson Cancer Center, Department of Infectious Diseases, 1515 Holcombe Blvd, Houston, TX 77030, USA. hhanna@mdanderson.org
Hend
H
Hanna
Robert
R
Benjamin
Ioannis
I
Chatzinikolaou
Badie
B
Alakech
Deborah
D
Richardson
Paul
P
Mansfield
Tanya
T
Dvorak
Mark F
MF
Munsell
Rabih
R
Darouiche
Hagop
H
Kantarjian
Issam
I
Raad
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016470:Bacteremia / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage*; D009369:Neoplasms / Q000150:complications*; D011446:Prospective Studies; D012293:Rifampin / Q000008:administration & dosage*; D012828:Silicones
D000900:Anti-Bacterial Agents; D012828:Silicones; D008911:Minocycline; D012293:Rifampin