title: Antibiotic lock with vancomycin and urokinase can successfully treat colonized central venous catheters in pediatric cancer patients.
abstract: We used an antibiotic lock technique with vancomycin in combination with urokinase in 10 consecutive eligible children with Gram-positive catheter-related bacteremia persisting after appropriate intravenous antibiotics. Treatment was successful in sterilizing all colonized central venous catheters, avoiding device removal and delay of further chemotherapy. The antibiotic lock technique may represent a safe and effective therapeutic option in patients with selected, uncomplicated catheter-related bacteremias resistant to systemic antimicrobial therapy, particularly when maintaining a venous access is mandatory.
authors.affiliation: Division of Pediatric Oncology, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: De Sio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Jenkner
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Milano
authors.forename: Ilaria
authors.initials: I
authors.lastname: Ilari
authors.forename: Paola
authors.initials: P
authors.lastname: Fidani
authors.forename: Aurora
authors.initials: A
authors.lastname: Castellano
authors.forename: Roberta
authors.initials: R
authors.lastname: Gareri
authors.forename: Alberto
authors.initials: A
authors.lastname: Donfrancesco
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D014640:Vancomycin; D014568:Urokinase-Type Plasminogen Activator