title: Rifampicin-miconazole-impregnated catheters save cost in jugular venous sites with tracheostomy.
abstract: Antimicrobial-impregnated catheters are more expensive than standard catheters (S-C). A higher incidence of catheter-related bloodstream infection (CRBSI) has been found in jugular venous access with tracheostomy than without tracheostomy. The objective of this study was to determine central venous catheter (CVC)-related costs (considering only the cost of the CVC, diagnosis of CRBSI, and antimicrobial agents used to treat CRBSI) using rifampicin-miconazole-impregnated catheters (RM-C) or S-C in jugular venous access with tracheostomy. We performed a retrospective cohort study of patients admitted to the intensive care unit (ICU) with tracheostomy who received one or more jugular venous catheters. RM-C showed a lower incidence of CRBSI compared with S-C (0 vs. 20.16 CRBSI episodes/1,000 catheter-days; odds ratio=0.05; 95% confidence interval=0.001-0.32; p<0.001) and lower CVC-related costs (including the cost of the CVC, diagnosis, and treatment of CRBSI) (<euro>11.46 ± 6.25 vs. <euro>38.11 ± 77.25; p<0.001) in jugular venous access with tracheostomy. The use of RM-C could reduce CVC-related costs in jugular venous access with tracheostomy. The results of our study may contribute to clinical decision-making and selection of those patients who could benefit from the use of antimicrobial-impregnated catheters.
authors.affiliation: Department of Critical Care, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320, Santa Cruz de Tenerife, Spain. lorentemartin@msn.com
authors.forename: L
authors.initials: L
authors.lastname: Lorente
authors.forename: M
authors.initials: M
authors.lastname: Lecuona
authors.forename: M J
authors.initials: MJ
authors.lastname: Ramos
authors.forename: A
authors.initials: A
authors.lastname: Jiménez
authors.forename: M L
authors.initials: ML
authors.lastname: Mora
authors.forename: A
authors.initials: A
authors.lastname: Sierra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology*; D055499:Catheter-Related Infections / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000191:economics / Q000379:methods*; D062905:Central Venous Catheters; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000191:economics / Q000379:methods*; D008297:Male; D008825:Miconazole / Q000494:pharmacology*; D008875:Middle Aged; D012189:Retrospective Studies; D012293:Rifampin / Q000494:pharmacology*; D014139:Tracheostomy
chemical_list: D000890:Anti-Infective Agents; D008825:Miconazole; D012293:Rifampin