title: Taurolidine lock in home parenteral nutrition in adults: results from an open-label randomized controlled clinical trial.
abstract: OBJECTIVE
  Many techniques have been tested to reduce the incidence of catheter-relater bloodstream infections (CRBSIs) during home parenteral nutrition (HPN). One of these methods, taurolidine lock, has shown some potential in several studies, but it has been studied primarily in patients with a relatively high CRBSI rate. Therefore, the aim of this study was to analyze the clinical value of taurolidine in patients receiving HPN who have a low infection rate.
  
  
  METHODS
  The CRBSI ratio at the Skawina HPN center has remained at 0.3-0.4 episodes/patient/y for the past 7 years. In November 2012, 30 patients (17 men, 13 women, mean age 52.3 years) were randomized to 1 of 3 groups: 2% taurolidine lock (group A), 1.35% taurolidine + citrate lock (B), and control-saline flush (C). Patients were observed for 12 consecutive months for catheter-related complications. Blood cultures were collected in each case in which an infection was suspected.
  
  
  RESULTS
  The total number of catheter days reached 10,968, with the following number of days per group: group A, 3658; group B, 3650; and group C, 3660. No complications were observed in the control group, while patients in the study groups had 1 catheter infection (group A) and 1 occlusion (group B). The CRBSIs were treated successfully with antibiotics. The cost of treatment in groups A and B was significantly higher than that in group C (P < .05).
  
  
  CONCLUSIONS
  The study did not observe any additional clinical value of taurolidine in patients receiving HPN who have a low infection rate and found low cost-effectiveness. Taurolidine should most likely be used only in patients with a high CRBSI rate.
authors.affiliation: Stanley Dudrick's Memorial Hospital, General and Oncology Surgery Unit, Skawina, Poland klek@poczta.onet.pl.
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Klek
authors.affiliation: Stanley Dudrick's Memorial Hospital, General and Oncology Surgery Unit, Skawina, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Szczepanek
authors.affiliation: Department of Pediatric Surgery, Medical University of Bialystok, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Hermanowicz
authors.affiliation: Jagiellonian University Medical College, Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Krakow, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Galas
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects* / Q000382:microbiology; D005260:Female; D016469:Fungemia / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects*; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology / Q000517:prevention & control*; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013829:Thiadiazines / Q000627:therapeutic use*
chemical_list: D000890:Anti-Infective Agents; D013829:Thiadiazines; D013654:Taurine; C012566:taurolidine
keywords: catheter infection; home parenteral nutrition; taurolidine