title: Central venous catheters and catheter locks in children with cancer: a prospective randomized trial of taurolidine versus heparin.
abstract: BACKGROUND
  To determine if the catheter lock taurolidine can reduce the number of catheter-related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC).
  
  
  METHODS
  During a study period of 34 months, 129 newly placed tunneled CVCs in 112 patients were randomly assigned to standard lock with heparin solution or experimental lock with a taurolidine solution (ClinicalTrials.gov Identifier NCT00735813).
  
  
  RESULTS
  Sixty-five CVCs were included in the standard group and 64 CVCs in the experimental group. The groups were comparable regarding patients' characteristics. A total number of 72 bloodstream infections of which 33 were CRBSIs were observed during 39,127 CVC-days. A lower rate of CRBSI (0.4 per 1,000 CVC-days) was observed in the experimental arm compared with the standard arm (1.4 per 1,000 CVC-days, incidence rate ratio (IRR) = 0.26; 95% confidence interval (CI) 0.09-0.61; P = 0.001). A lower rate of total bloodstream infections (1.2 per 1,000 CVC-days) was also observed in the experimental arm compared with the standard arm (2.5 per 1,000 CVC-days, IRR = 0.49; 95% CI 0.29-0.82; P = 0.004). Median interval from catheter insertion until first CRBSI was significantly lower in the standard group (156 days, range 12-602) compared with the experimental group (300 days, range 12-1,176; P = 0.02). Premature removal of the CVC due to infection and overall CVC survival were similar in the two study groups.
  
  
  CONCLUSIONS
  Locking of long-term tunneled CVC with taurolidine significantly reduces catheter-related bloodstream infections in children with cancer.
authors: Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus N, Denmark. handrup@ki.au.dk
authors: Mette Møller
authors: MM
authors: Handrup
authors: Jens Kjølseth
authors: JK
authors: Møller
authors: Henrik
authors: H
authors: Schrøder
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D062905:Central Venous Catheters; D002648:Child; D002675:Child, Preschool; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D007239:Infections / Q000188:drug therapy*; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D013654:Taurine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013829:Thiadiazines / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000890:Anti-Infective Agents; D000925:Anticoagulants; D013829:Thiadiazines; D013654:Taurine; C012566:taurolidine; D006493:Heparin