Antibiotic lock technique reduces the incidence of temporary catheter-related infections.
BACKGROUND
In the hemodialytic population, infections are the second leading cause of death; access infections account for a large proportion of this mortality. The antibiotic lock technique has been applied to infected tunneled catheters as rescue or prophylaxis medication to reduce infection rates. In addition, application of topical antibiotic ointments to tunneled and non-tunneled catheters also prevents exit site infections.


METHODS
17 patients with 25 catheters participated in our study from March 2004 - February 2005. The catheter lock comprised of mixed cefazolin (5 mg/dl) with heparin (2,500 IU/ml) and mupirocin was topically applied to the area (2 x 2 cm) surrounding the catheter exit site.


RESULTS
The catheter infection rate was reduced from 12.7 times/1,000 catheter days to 5.02 times/1,000 catheter days in patients with jugular vein catheters. The total catheter-related infection rate was 14.9 times/1,000 catheter days in the control group and 4.1 times/1,000 catheter days in the study group. The reduction in catheter infections was more evident in a subgroup of non-diabetic patients, and in those with femoral catheters.


CONCLUSIONS
The use of antibiotic lock and topical antibiotics significantly reduces the incidence of temporary catheter-related infections, especially in non-diabetic patients and in those with femoral catheters.
Chiou
P F
PF
Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, R.O.C.
Chang
C C
CC
Wen
Y K
YK
Yang
Y
Y
D000287:Administration, Topical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D019072:Antibiotic Prophylaxis / Q000379:methods*; D016470:Bacteremia / Q000453:epidemiology; D002404:Catheterization / Q000009:adverse effects*; D002437:Cefazolin / Q000494:pharmacology; D035061:Control Groups; D003428:Cross Infection / Q000517:prevention & control*; D004866:Equipment Contamination / Q000517:prevention & control*; D004890:Erythema / Q000453:epidemiology; D005260:Female; D005402:Fistula / Q000453:epidemiology; D006436:Hemodialysis Units, Hospital; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D015994:Incidence; D007239:Infections / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000008:administration & dosage; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality / Q000706:statistics & numerical data
D000900:Anti-Bacterial Agents; D006493:Heparin; D016712:Mupirocin; D002437:Cefazolin