Antimicrobial central venous catheters in oncology: efficacy of a rifampicin-miconazole-releasing catheter.
Antimicrobial central venous catheters are discussed as a device to reduce catheter-related infections. Previously we have reported a study with 223 adult surgical patients randomized to receive either a rifampicin-miconazole-loaded central venous catheter (CVC) (n=118) or a standard CVC (n=105). The antimicrobial CVC was shown to reduce catheter colonization (CC) and catheter-related local infection (CRI) significantly even at long-term catheterization. Here, we present further evaluation of the study focusing on possible benefits for high-risk patients. Subgroup analyses showed a pronounced reduction of CC and CRI in male, overweight and oncology patients. Important covariates were skin colonization for CC and oncological disease for CRI. Odds ratio (OR) for reducing CC was 0.076 (95% CI: 0.016-0.360) and CRI was reduced from 26% to 2.3% (p=0.001) in the cancer subgroup. Ex vivo long-term antimicrobial activity of modified catheters exceeded 4 weeks.


CONCLUSIONS
Immunocompromized patients suffering from cancer, transplantation, and dialysis patients with a long-term vascular access may mostly benefit from rifampicin-miconazole-releasing catheters.
Institute for Naturopathy, University Hospital of Cologne, Köln, Germany.
Jörg Michael
JM
Schierholz
Klaus
K
Nagelschmidt
Manfred
M
Nagelschmidt
Rolf
R
Lefering
Nedim
N
Yücel
Josef
J
Beuth
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000379:methods*; D002408:Catheters, Indwelling / Q000382:microbiology; D020099:Coated Materials, Biocompatible / Q000008:administration & dosage*; D004866:Equipment Contamination / Q000517:prevention & control; D005260:Female; D006090:Gram-Negative Bacteria / Q000254:growth & development / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000254:growth & development / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008825:Miconazole / Q000008:administration & dosage*; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control; D009369:Neoplasms / Q000382:microbiology / Q000628:therapy*; D012293:Rifampin / Q000008:administration & dosage*; D012307:Risk Factors; D055815:Young Adult
D000904:Antibiotics, Antitubercular; D000935:Antifungal Agents; D020099:Coated Materials, Biocompatible; D008825:Miconazole; D012293:Rifampin