Successful prevention of cuffed hemodialysis catheter-related infection using an antibiotic lock technique by strictly catheter-restricted antibiotic lock solution method.
BACKGROUND
Catheter-related infection (CRI) is associated with increased all-cause mortality and morbidity in hemodialysis patients and may be reduced by using antimicrobial lock solutions. But the safety of long-term use of antimicrobial lock still needs to be defined.


METHODS
Patients with a new inserted permanent tunneled cuffed hemodialysis catheter were randomly assigned to an antibiotic lock solution of gentamicin (4 mg/ml) heparin (G group) or heparin alone (H group).


RESULTS
A total of 140 patients were enrolled in this study. CRI rates were 0.06/1,000 catheter-days for the G group versus 0.67 in the H group (p = 0.014). The risk of CRI was 10.54 higher in patients with a heparin-alone locked catheter (p = 0.025) than that with gentamicin. The serum-measured gentamicin levels were very low.


CONCLUSIONS
Gentamicin lock solution reduces CRI and improves catheter survival rates in hemodialysis patients. It is relatively safe in strictly catheter-restricted antibiotic lock solution therapy.
Zhang
Ping
P
Kidney Disease Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China.
Yuan
Jing
J
Tan
Huizhen
H
Lv
Rong
R
Chen
Jianghua
J
D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000097:blood; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*
D005839:Gentamicins; D006493:Heparin