title: Linezolid versus vancomycin antibiotic lock solution for the prevention of nontunneled catheter-related blood stream infections in hemodialysis patients: a prospective randomized study.
abstract: The use of antibiotic lock solutions (ALSs) for the prevention of catheter-related blood stream infections (CRBSIs) is a promising option. The efficacy and safety of linezolid as ALS were evaluated in a randomized double-blind prospective study where 131 patients who required nontunneled catheter (NTC) for hemodialysis (HD) were randomized to receive an ALS with either (A) unfractionated heparin (2000 U/ml) alone as a catheter lock control, (B) vancomycin (5 mg/ml) + heparin (2000 U/ml), or (C) linezolid (2 mg/ml) + heparin (2000 U/ml). The primary endpoint of the study was CRBSI. A total of 152 NTCs were inserted in 131 patients. The linezolid-locked group did not present any infective episode (CRBSI rate = 0/1000 catheter days) compared with 2 episodes in the vancomycin-locked group (CRBSI rate = 1.21/1000 catheter days, p = 0.1021) and 11 episodes in the heparin-locked group (CRBSI rate = 6.7/1000 catheter days, p = 0.0001). Median number of catheter days was greater in group C (median = 38) compared with group B (median = 36, p = 0.0415) and with group A (median = 34, p = 0.0036). No side effects and no resistant organisms were recorded with the use of linezolid ALS. Linezolid appears to be a safe and effective ALS, preventing CRBSI and prolonging the survival of the catheter in HD patients.
authors.affiliation: General Hospital of Nikea-Piraeus, Athens, Greece. ssofron21@gmail.com
authors.forename: Sofia
authors.initials: S
authors.lastname: Sofroniadou
authors.forename: Ioanna
authors.initials: I
authors.lastname: Revela
authors.forename: Despina
authors.initials: D
authors.lastname: Smirloglou
authors.forename: Ioanna
authors.initials: I
authors.lastname: Makriniotou
authors.forename: Sinodi
authors.initials: S
authors.lastname: Zerbala
authors.forename: Alexandros
authors.initials: A
authors.lastname: Kouloubinis
authors.forename: George
authors.initials: G
authors.lastname: Samonis
authors.forename: Christos
authors.initials: C
authors.lastname: Iatrou
mesh_terms: D000081:Acetamides; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000382:microbiology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D023303:Oxazolidinones; D011446:Prospective Studies; D012338:RNA, Ribosomal, 23S; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D012338:RNA, Ribosomal, 23S; D014640:Vancomycin; D000069349:Linezolid