TY - JOUR
T1 - Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections
T2 - A randomized, double-blind trial
AU - Raad, Issam
AU - Darouiche, Rabih
AU - Dupuis, Jacques
AU - Abi-Said, Dima
AU - Gabrielli, Andrea
AU - Hachem, Ray
AU - Wall, Matthew
AU - Harris, Richard
AU - Jones, James
AU - Buzaid, Antonio
AU - Robertson, Claudia
AU - Shenaq, Salwa
AU - Curling, Patrick
AU - Burke, Thomas W
AU - Ericsson, Charles
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1997/8/15
Y1 - 1997/8/15
N2 - Background: Central venous catheters are a principal source of nosocomial bloodstream infections, which are difficult to control. Objective: To determine the efficacy of catheters coated with minocycline and rifampin in preventing catheter-related colonization and bloodstream infections. Design: Multicenter, randomized clinical trial. Setting: Five university- based medical centers. Patients: 281 hospitalized patients who required 298 triple-lumen, polyurethane venous catheters. Intervention: 147 catheters were pretreated with tridodecylmethyl-ammonium chloride and coated with minocycline and rifampin. Untreated, uncoated catheters (n = 151) were used as controls. Measurements: Quantitative catheter cultures, blood cultures and molecular typing of organisms to determine catheter-related colonization and bloodstream infections. Results: The group with coated catheters and the group with uncoated catheters were similar with respect to age, sex, underlying diseases, degree of immunosuppression, therapeutic interventions, and risk factors for catheter infections. Colonization occurred in 36 (26%) uncoated catheters and 11 (8%) coated catheters (P < 0.001). Catheter- related bloodstream infection developed in 7 patients (5%) with uncoated catheters and no patients with coated catheters (P < 0.01). Multivariate logistic regression analysis showed that coating catheters with minocycline and rifampin was an independent protective factor against catheter-related colonization (P < 0.05). No adverse effects related to the coated catheters or antimicrobial resistance were seen. An estimate showed that the use of coated catheters could save costs. Conclusions: Central venous catheters coated with minocycline and rifampim can significantly reduce the risk for catheter-related colonization and bloodstream infections. The use of these catheters may save costs.
AB - Background: Central venous catheters are a principal source of nosocomial bloodstream infections, which are difficult to control. Objective: To determine the efficacy of catheters coated with minocycline and rifampin in preventing catheter-related colonization and bloodstream infections. Design: Multicenter, randomized clinical trial. Setting: Five university- based medical centers. Patients: 281 hospitalized patients who required 298 triple-lumen, polyurethane venous catheters. Intervention: 147 catheters were pretreated with tridodecylmethyl-ammonium chloride and coated with minocycline and rifampin. Untreated, uncoated catheters (n = 151) were used as controls. Measurements: Quantitative catheter cultures, blood cultures and molecular typing of organisms to determine catheter-related colonization and bloodstream infections. Results: The group with coated catheters and the group with uncoated catheters were similar with respect to age, sex, underlying diseases, degree of immunosuppression, therapeutic interventions, and risk factors for catheter infections. Colonization occurred in 36 (26%) uncoated catheters and 11 (8%) coated catheters (P < 0.001). Catheter- related bloodstream infection developed in 7 patients (5%) with uncoated catheters and no patients with coated catheters (P < 0.01). Multivariate logistic regression analysis showed that coating catheters with minocycline and rifampin was an independent protective factor against catheter-related colonization (P < 0.05). No adverse effects related to the coated catheters or antimicrobial resistance were seen. An estimate showed that the use of coated catheters could save costs. Conclusions: Central venous catheters coated with minocycline and rifampim can significantly reduce the risk for catheter-related colonization and bloodstream infections. The use of these catheters may save costs.
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U2 - 10.7326/0003-4819-127-4-199708150-00002
DO - 10.7326/0003-4819-127-4-199708150-00002
M3 - Article
C2 - 9265425
AN - SCOPUS:0030753776
SN - 0003-4819
VL - 127
SP - 267
EP - 274
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 4
ER -