title: Short-dwell ethanol lock therapy in children is associated with increased clearance of central line-associated bloodstream infections.
abstract: BACKGROUND
  Central line-associated bloodstream infection (CLABSI) is a known complication of central line use. Salvage of infected central lines with ethanol lock therapy (ELT) with systemic antimicrobials may be an alternative treatment option in children.
  
  
  METHODS
  Retrospective review was performed in children with CLASBI who underwent short-dwell ELT (70% ethanol, 4- to 25-hour dwell times ≤3 days) with systemic antimicrobials from January 1, 2007 to July 15, 2009.
  
  
  RESULTS
  A total of 59 patients, aged 2 months to 19 years (mean ± SD = 6.3 ± 6.1 years) with 80 episodes of CLABSI were included. The CLABSI eradication rate was 86% (69/80 episodes; 95% confidence interval [CI] 78%, 94%), significantly greater than 50% (Z = 2.35, P < .05), the estimated clearance rate of CLABSI eradication using systemic antimicrobials alone. Overall central line retention was 78% (60/77 episodes, 95% CI 69%, 87%). ELT was well tolerated.
  
  
  CONCLUSIONS
  These findings suggest the potential benefit of short-dwell ELT combined with systemic antimicrobials in CLABSI treatment. Randomized controlled trials are needed.
authors.affiliation: Children's Hospital of Michigan, Detroit, MI, USA. emcgrath@med.wayne.edu
authors.forename: Eric J
authors.initials: EJ
authors.lastname: McGrath
authors.forename: Ralph
authors.initials: R
authors.lastname: Salloum
authors.forename: Xinguang
authors.initials: X
authors.lastname: Chen
authors.forename: Yifan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Kathrina
authors.initials: K
authors.lastname: Boldt-MacDonald
authors.forename: Cristie
authors.initials: C
authors.lastname: Becker
authors.forename: Roland
authors.initials: R
authors.lastname: Chu
authors.forename: Jocelyn Y
authors.initials: JY
authors.lastname: Ang
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000188:drug therapy / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000517:prevention & control*; D004866:Equipment Contamination / Q000517:prevention & control; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D000431:Ethanol