A Randomized Double-Blind Controlled Trial of Taurolidine-Citrate Catheter Locks for the Prevention of Bacteremia in Patients Treated With Hemodialysis

Efficacy of taurolidine against periodontopathic species—an in vitro study

“…Concluding from our results showing a time-dependent antimicrobial effect of taurolidine at a later time-point differences might be less remarkable between the two antimicrobials. A depot effect can be suggested for taurolidine, as a lock solution, prevents successful infections in catheters [39]. Biofilms are organized microbial communities surrounded by a biopolymer matrix and characterized by slow growth, increasing mutation frequency, and maximum tolerance to antibiotics [40]; the special conditions of biofilms should be addressed in subsequent studies testing taurolidine.…”

“…It is well-established that periodontopathic bacteria are able to attach and to invade epithelial cells [42,43], while polymorphonuclear neutrophils interacting with periodontopathic bacteria release reactive oxidative species [44], which in turn damage the soft and hard periodontal tissues. Taurolidine has been demonstrated to inhibit adhesion of Escherichia coli, Staphylococcus saprophyticus, and C. albicans to mucosal epithelial cells [3] and of Gram-negative species to plastic surfaces [39]. Taurolidine derivatives decrease production of proinflammatory cytokines and oxidants [45].…”

Reducing Catheter-Related Infections in Hemodialysis Patients

“…However, a recent meta-analysis by Zhao et al indicated that low-to-moderate concentrations of citrate (1.04%-7%) appear to be of benefit in decreasing the risk for CRBSI (27). The combination of citrate with other novel antimicrobials, such as taurolidine (28)(29)(30)(31) and methylene blue-methylparaben-propylparaben, has shown efficacy in reducing CRBSI, but issues with catheter thrombosis have limited their use (18). Hemmelgarn et al reported successful reduction in CRBSI with the use of once-weekly tissue plasminogen activator, but the longterm cost of this strategy is prohibitive (32).…”

Hemodialysis Access Infections, Epidemiology, Pathogenesis and Prevention

“…The main drawback to using Taurolidine-citrate locks is a greater need for thrombolytic therapy. Solomon et al (2010) surmised that tauroldine-citrate usage impacted only infection of intraluminal origin and that better formulations with an improved anticoagulant profile should be sought. These findings echo those trends seen previously (Allon, 2003, Betjes andVan Agteren 2004;Taylor et al, 2008).…”