title: Impact of a national shortage of sterile ethanol on a home parenteral nutrition practice: a case series.
abstract: Catheter-related bloodstream infection (CRBSI) is a common and life-threatening infectious complication of home parenteral nutrition (PN). CRBSI is associated with hospital admissions, morbidity, mortality, loss of venous access, and healthcare costs. Ethanol has bactericidal and fungicidal properties, making it an ideal locking solution for preventing CRBSI. The authors report 6 patients with a recurrence of CRBSI when ethanol lock (ETL) was withheld due to a national shortage. This is the first known report of the ramifications of a national ethanol shortage on redevelopment of CRBSI in home PN patients with a history of CRBSIs. This series further supports the existing literature showing that ETL is a viable therapy for the prevention of CRBSIs, warranting prospective research. The impact of an ethanol shortage due to a sole-source manufacturer supports the need for the Food and Drug Administration to regulate pharmaceutical products to avoid shortages.
authors.affiliation: Nutrition Support Team, Cleveland Clinic, Cleveland, Ohio 44195, USA. corrigm5@ccf.org
authors.forename: Mandy
authors.initials: M
authors.lastname: Corrigan
authors.forename: Donald F
authors.initials: DF
authors.lastname: Kirby
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D000431:Ethanol / Q000600:supply & distribution*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects*; D012008:Recurrence; D013242:Sterilization / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000431:Ethanol