Antimicrobial lock therapy in central-line associated bloodstream infections: a systematic review

Abstract

The introduction of novel molecules has increased chances of catheter salvage with ALT in case of CLABSI, but further in vivo studies are needed.

Antimicrobial Efficacy and Safety of a Novel Gas Plasma-Activated Catheter Lock Solution

“…For C. albicans 14053, M-EDTA-25E required 6 hours to achieve similar eradication and regrowth suppression. This is broadly in line with the capability of current ALT that generally requires prolonged lock times (29,30).…”

“…Variable efficacy has been reported for current ALT and antifungal lock therapy (AŕLT) (29,30). For PAD therapy, effective lock times were approximately 60 minutes against the Gram-positive and Gram-negative bacteria, and C. albicans we studied (Table 1, 2 and Figure 2).…”

Effects of Ethanol Lock Therapy on Central Line Infections and Mechanical Problems in Children With Intestinal Failure

“…A recent study showed that a lock solution containing 7% citrate, 20% ethanol, and 0.01% glyceryl trinitrate is able to fully eradicate biofilm organisms in vitro, without causing plasma protein precipitation 34 . Similarly, 2% taurolidine, an antimicrobial chemotherapeutic agent, used as lock therapy resulted in a decrease in the rates of CRBSIs due to gram‐positive and gram‐negative organisms while also decreasing rates of catheter occlusions when compared with heparin 35 . ‐ 37 These agents merit further clinical evaluation.…”

Microbial Biofilms in Pulmonary and Critical Care Diseases

“…At present, disruption of biofilms is largely limited to the removal of colonized catheters, and this is recommended whenever feasible because of the limited activity of antimicrobials in eradicating established biofilms. Although clinical and in vivo efficacy data are limited, antibiotic lock therapy, which consists of instilling high concentrations of antibiotic within the catheter to eradicate the adherent biofilm, may be used as adjuvant therapy to salvage permanent indwelling catheters in some situations (94). Although C. albicans biofilms show in vitro resistance to echinocandins, these drugs display excellent activity in vivo, where they can disperse preformed catheter-associated biofilms (95), enhance immune recognition and fungal killing (27,(96)(97)(98), and completely eradicate catheter-associated infections (99).…”