A prospective double-blind randomized trial comparing intraluminal ethanol with heparinized saline for the prevention of catheter-associated bloodstream infection in immunosuppressed haematology patients.
OBJECTIVE
The aim of this study was to prospectively evaluate the use of intraluminal ethanol for the prevention of catheter-associated bloodstream infection (CABSI) in immunosuppressed haematology patients.


METHODS
Patients receiving chemotherapy for haematological malignancy or haematopoietic cell transplantation were randomized in a double-blinded manner to receive either intraluminal 70% ethanol/water or heparinized saline locks on a daily basis throughout a prophylactic treatment period. The primary endpoint was an episode of CABSI (defined as 'bacteraemia in a febrile patient with a central venous catheter that was in use within the preceding 48 h and with no other identified focus of infection'). The trial was registered with the Australian Clinical Trials Register: number ACTRN012605000383662.


RESULTS
There were 34 and 30 prophylactic treatment periods in the ethanol and control groups, respectively. CABSI occurred in 3 (9%, 0.60/100 catheter-days) and 11 (37%, 3.11/100 catheter-days) prophylactic treatment periods in the ethanol and control groups, respectively (OR = 0.18, 95% CI 0.05-0.65, P = 0.008). Eleven (32%) and 5 (17%) patients in the ethanol and control groups, respectively, remained afebrile throughout the prophylactic treatment (P = 0.18).


CONCLUSIONS
The daily administration of ethanol locks into lumens of central venous catheters effectively reduces the incidence of CABSI.
Sanders
Joanne
J
Department of Pathology, Christchurch School of Medicine and Health Sciences, Otago University, Christchurch, New Zealand.
Pithie
Alan
A
Ganly
Peter
P
Surgenor
Lois
L
Wilson
Rachel
R
Merriman
Eileen
E
Loudon
Gail
G
Judkins
Rhonda
R
Chambers
Stephen
S
D016470:Bacteremia / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004202:Disinfectants / Q000494:pharmacology; D004311:Double-Blind Method; D000431:Ethanol / Q000494:pharmacology*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012965:Sodium Chloride / Q000494:pharmacology*
D004202:Disinfectants; D000431:Ethanol; D012965:Sodium Chloride