skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8847

Clinical outcomes of antimicrobial lock solutions used in a treatment modality: a retrospective case series analysis

Original Research

(2807) Views  (1077) Full article downloads

Authors: P Brandon Bookstaver, Katherine R Gerrald, Robert R Moran

Published Date June 2010 Volume 2010:2 Pages 123 - 130
DOI: http://dx.doi.org/10.2147/CPAA.S11262

P Brandon Bookstaver1, Katherine R Gerrald2, Robert R Moran3

1South Carolina College of Pharmacy, 3Health Science Research Core, University of South Carolina, Columbia, SC, USA; 2University of North Carolina Hospitals, Chapel Hill, NC, USA

Background: Antimicrobial lock therapy (ALT) may be considered as adjunctive therapy in the treatment of catheter-related bloodstream infections (CRBSI) when catheter removal is not a favorable option.

Objective: To evaluate the outcomes associated with ALT as adjunctive treatment of CRBSI.

Methods: This was a 24-month retrospective case series analysis evaluating patients treated for more than 24 hours with ALT. The primary outcome was blood culture sterilization for 30 days posttherapy. The impact of ALT duration and time to initiation on central venous catheter (CVC) salvage were evaluated. Logistic regression modeled the association between ALT and sterilization rates, with a prespecified level of significance (α) of 0.1.

Results: Twenty-six cases were included in data analysis. Patients included ranged from 5 months to 82 years of age; 77% of patients were receiving total parenteral nutrition or chemotherapy. The majority of patients received vancomycin, daptomycin, or gentamicin combined with heparin in a lock solution. Blood culture sterilization was achieved in 69.2% of cases, and sterilization plus CVC retention was achieved in 11 cases (42.3%). Longer durations of ALT (≥9 days) were significantly correlated with blood culture sterilization (odds ratio = 1.367, P = 0.077).

Conclusion: ALT used as an adjunct to systemic therapy for adequate duration in CRBSI can achieve CVC sterilization and retainment without subsequent infectious complications.

Keywords: antimicrobial lock therapy, central venous catheter, bacteremia, central lineassociated bloodstream infection






 

Other articles by Dr Brandon Bookstaver



Readers of this article also read:

Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors
The pathophysiology of bronchiectasis
Health literacy and health seeking behavior among older men in a middle-income nation
Rituximab in severe skin diseases: target, disease, and dose
Retinal nerve fiber layer evaluation in multiple sclerosis with spectral domain optical coherence tomography
Clinical efficacy of beta1 selective adrenergic blockers in the treatment of neurocardiogenic syncope – a meta-analysis
Erratum
Cumulative clinical experience from over a decade of use of levofloxacin in community-acquired pneumonia: critical appraisal and role in therapy
Drug-resistant tuberculosis: emerging treatment options
Role of denosumab in the management of skeletal complications in patients with bone metastases from solid tumors
  • Testimonials

    "... I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University