title: Prevention of hemodialysis catheter-related blood stream infections using a cotrimoxazole-lock technique.
abstract: OBJECTIVE
  This trial assessed the efficacy of cotrimoxazole lock solution in reducing catheter-related blood stream infections (CRBSIs) among hemodialysis (HD) patients who were dialyzed using tunneled catheters.
  
  
  METHODS
  Patients randomly received either heparin (2500 U/ml) (control group) or a mixture of 10 mg/ml cotrimoxazole (based on trimethoprim) and 2500 U/ml heparin (antibiotic group) as catheters lock solution.
  
  
  RESULTS
  Compared with the control group, CRBSIs rates per 1000 catheter-days was significantly lower (0.58 vs 4.4 events; p = 0.002) and cumulative infection-free catheter survival was significantly higher (log rank statistic 5.88; p = 0.015) in the antibiotic group. There were no statistical differences regarding incidences of catheter removal (8.7% in the antibiotic group vs 22% in the control group; p = 0.116) or thrombosis (2.2% in the antibiotic group vs 9.8% in the control group; p = 0.129) between the two groups.
  
  
  CONCLUSIONS
  cotrimoxazole containing catheter lock solution is effective in reducing CRBSIs incidence and prolonging dialysis catheter survival in HD patients.
authors.affiliation: Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Moghaddas
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Abbasi
authors.forename: Afshin
authors.initials: A
authors.lastname: Gharekhani
authors.forename: Simin
authors.initials: S
authors.lastname: Dashti-Khavidaki
authors.forename: Effat
authors.initials: E
authors.lastname: Razeghi
authors.forename: Atefeh
authors.initials: A
authors.lastname: Jafari
authors.forename: Hossein
authors.initials: H
authors.lastname: Khalili
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000517:prevention & control*; D001769:Blood / Q000382:microbiology; D055499:Catheter-Related Infections / Q000517:prevention & control*; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage*; D062666:Vascular Access Devices / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D006493:Heparin
keywords: antibiotic lock solution; catheter-related bacteremia; cotrimoxazole; tunneled hemodialysis catheter