The use of rifampicin-miconazole-impregnated catheters reduces the incidence of femoral and jugular catheter-related bacteremia.
BACKGROUND
The guidelines of the Centers for Disease Control and Prevention do not recommend the use of an antimicrobial- or antiseptic-impregnated catheter for short-term use. In previous studies, we have found a higher incidence of central venous catheter-related bacteremia among patients with femoral and central jugular accesses than among patients with other venous accesses.


OBJECTIVE
The objective of our study was to determine the incidence of central venous catheter-related bacteremia associated with rifampicin-miconazole-impregnated catheters and standard catheters in patients with femoral and central jugular venous accesses.


METHODS
This was a cohort study, conducted in the 24-bed polyvalent medical-surgical intensive care unit of a university hospital. We included patients who were admitted to the intensive care unit from 1 June 2006 through 30 September 2007 and who underwent femoral or central jugular venous catheterization.


RESULTS
We inserted 184 femoral (73 rifampicin-miconazole-impregnated catheters and 111 standard catheters) and 241 central jugular venous catheters (114 rifampicin-miconazole-impregnated catheters and 127 standard catheters). We found a lower rate of central venous catheter-related bacteremia associated with rifampicin-miconazole-impregnated catheters than with standard catheters among patients with femoral access (0 vs. 8.62 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.86; P = .03) and among patients with central internal jugular access (0 vs. 4.93 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.93; P = .04).


CONCLUSIONS
Rifampicin-minonazole-impregnated catheters are associated with a statistically significant reduction in the incidence of catheter-related bacteremia in patients with short-term catheter use at the central jugular and femoral sites.
Lorente
Leonardo
L
Department of Critical Care, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain. lorentemartin@msn.com
Lecuona
María
M
Ramos
María José
MJ
Jiménez
Alejandro
A
Mora
María L
ML
Sierra
Antonio
A
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D020099:Coated Materials, Biocompatible; D015331:Cohort Studies; D005260:Female; D005268:Femoral Vein; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008825:Miconazole / Q000008:administration & dosage; D008875:Middle Aged; D012293:Rifampin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D008825:Miconazole; D012293:Rifampin