Clinical and economic impact of the taurolidine lock on home parenteral nutrition

Arnoriaga-Rodríguez, María; Cordeu, Maite Perez de Ciriza; Álvarez, Manuel; Lesmes, Irene Bretón; Cámara, Marta Motilla de la; Gimeno, Cristina Velasco; Arhip, L.; Peris, Pilar; Compés, C. Cuerda

doi:10.20960/nh.1748

Cited by 3 publications

(11 citation statements)

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“…The cost-effectiveness of utilizing taurolidine has been suggested by studies assessing its use in the secondary prevention of CRBSIs. 19,22 Tribler et al 19 compared the use of taurolidine-citrateheparin against the use of heparin in patients who had ≥1 line-related infections within the previous 4 years. Using a fixed costing system, this demonstrated lower overall costs in the taurolidine-citrateheparin group, with reduced hospital admission days.…”

Section: Discussionmentioning

confidence: 99%

“…6,10,18 There is growing evidence surrounding the cost-effectiveness of taurolidine in the prevention of CRBSIs. 10,16,19,21,22 Historically, the majority of CRBSIs are associated with a small proportion of patients receiving HPN, 15 with taurolidine often initiated after the initial infection in these patients at high risk. Klek et al 23 compared the cost-effectiveness of taurolidine (2% taurolidine and 1.35% taurolidine-citrate solutions) with that of a control saline solution in a group of patients at low risk of CRBSI.…”

Section: Introductionmentioning

confidence: 99%

“…Subsequent studies have associated taurolidine use with lower costs in the secondary prevention of infections in patients at high risk of CRBSI. 10,16,19,21,22 Lannoy et al 16 demonstrated a 65% reduction in total costs per patient (from €11,176 to €3918) after the introduction of taurolidine (compared with that of saline flush) in patients at risk of CRBSI. Taurolidine has also been shown to reduce the total costs per year (€6743.9 to €2347 per treatment year), 19 costs per patient ($4454 to $1865 USD per patient), 21 and costs per day (€12.4 to €4.6 per day).…”

Section: Introductionmentioning

confidence: 99%

“…Taurolidine has also been shown to reduce the total costs per year (€6743.9 to €2347 per treatment year), 19 costs per patient ($4454 to $1865 USD per patient), 21 and costs per day (€12.4 to €4.6 per day). 22 There remains limited evidence on the financial impact of taurolidine use in the primary prevention of CRBSIs.…”

Section: Introductionmentioning

confidence: 99%

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Cost‐effectiveness of taurolidine‐citrate in a cohort of patients with intestinal failure receiving home parenteral nutrition

Williams,

Moy,

Kaazan

et al. 2023

J Parenter Enteral Nutr

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BackgroundCatheter‐related bloodstream infections (CRBSIs) in patients receiving home parenteral nutrition (HPN) for chronic intestinal failure (CIF) are associated with significant morbidity and financial costs. Taurolidine is associated with a reduction in bloodstream infections, with limited information on the cost‐effectiveness as the primary prevention. This study aimed to determine the cost‐effectiveness of using taurolidine‐citrate for the primary prevention of CRBSIs within a quaternary hospital.MethodsAll patients with CIF receiving HPN were identified between January 2015 and November 2022. Data were retrospectively collected regarding patient demographics, HPN use, CRBSI diagnosis, and use of taurolidine‐citrate. The direct costs associated with CRBSI‐associated admissions and taurolidine‐citrate use were obtained from the coding department using a bottom‐up approach. An incremental cost‐effective analysis was performed, with a time horizon of 4 years, to compare the costs associated with primary and secondary prevention against the outcome of cost per infection avoided.ResultsForty‐four patients received HPN within this period. The CRBSI rates were 3.25 infections per 1000 catheter days before the use of taurolidine‐citrate and 0.35 infections per 1000 catheter days after taurolidine‐citrate use. The incremental cost‐effectiveness ratio indicates primary prevention is the weakly dominant intervention, with the base case value of $27.04 per CRBSI avoided. This held with one‐way sensitivity analysis.ConclusionTaurolidine‐citrate in the primary prevention of CRBSIs in patients with CIF receiving HPN is associated with reduced hospital costs and infection rates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cost‐effectiveness of taurolidine‐citrate in a cohort of patients with intestinal failure receiving home parenteral nutrition

Williams,

Moy,

Kaazan

et al. 2023

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…Current PN guidelines recognize the effectiveness of taurolidine in preventing CRBSI and suggest its use during long-term catheter use, however, remain unclear regarding which patient groups would significantly benefit from its routine use (1). Given that prevention focused protocols are aimed to reduce CRBSI rates to <1/1000 catheter days (13), a variety of studies have assessed the prophylactic use of taurolidine line locks in pediatric patients on HPN, with unambiguously positive results; with multifold decrease in CRBSI rate, and financial benefits (14)(15)(16). Because the value of taurolidine has never been assessed in pediatric patients receiving HPN who have a low CRBSI rate, we have conducted a simplified cost-effectiveness analysis of routine use of taurolidine line locks in children on HPN.…”

Section: Discussionmentioning

confidence: 99%

Central Catheter‐related Bloodstream Infection Rates in Children on Home Parenteral Nutrition

Trivić

Mišak

Kerman

et al. 2020

J. pediatr. gastroenterol. nutr.

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Reliable venous access is prerequisite for patients receiving long-term parenteral nutrition (PN). Central venous catheters are, however, an important risk factor for the development of potentially lethal complications, including catheter-related bloodstream infection (CRBSI). We have retrospectively assessed the incidence of CRBSIs in children on long-term PN who were treated at the Children's Hospital Zagreb from January 2011 until January 2019 and the cost effectiveness of the use of taurolidine line locks in children at home PN (HPN). During this period 48 children received long-term PN and 24 children were discharged to HPN. The rate of CRBSI 1.15/1000 catheter days in total; 2.35/1000 days in the hospital; and 0.48/1000 days at home. If taurolidine line lock was used every day of PN for children on HPN total costs would exceed existing CRBSI treatment costs >5 times.

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Meta‐analysis of the efficacy of taurolidine in reducing catheter‐related bloodstream infections for patients receiving parenteral nutrition

Vernon‐Roberts

Lopez

Frampton

et al. 2022

J Parenter Enteral Nutr

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Background Parenteral nutrition administered via central venous catheter is an established treatment option for people with intestinal failure. A serious complication of central venous catheters is the high risk of catheter‐related bloodstream infections (CRBSIs). Catheter‐locking solutions are one strategy for CRBSI prevention, with the solution taurolidine showing beneficial effects. The aim of this meta‐analysis was to identify and synthesize evidence to assess taurolidine efficacy against comparators for the prevention of CRBSI for people with intestinal failure receiving parenteral nutrition. Methods Six health literature databases were searched for efficacy data of rate of CRBSI for taurolidine vs control among our study population; no study design limits were applied. Individual study data were presented for the number of CRBSIs and catheter days, and rate ratio. Overall data were synthesized as a pooled risk ratio, with subgroup analyses by study design, control type, and taurolidine solution. Results Thirty‐four studies were included in the final analysis. At the individual level, all studies showed superior efficacy of taurolidine vs control for prevention of CRBSIs. When the data were synthesized, the pooled risk ratio was 0.49 (95% CI, 0.46–0.53; P ≤ 0.0001), indicating a 51% decreased risk of CRBSI through the use of taurolidine. Subgroup analysis showed no difference depending on study design (P = 0.23) or control type (P = 0.37) and a significant difference for taurolidine type (P = 0.0005). Conclusion Taurolidine showed superior efficacy over controls regardless of study design or comparator group. The results show that taurolidine provides effective CRBSI reduction for people with intestinal failure receiving parenteral nutrition.

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Clinical and economic impact of the taurolidine lock on home parenteral nutrition

Abstract: our study shows that taurolidine lock is a cost-effective intervention in patients on HPN with high risk of CRBSI.

Cited by 3 publications

References 0 publications

Cost‐effectiveness of taurolidine‐citrate in a cohort of patients with intestinal failure receiving home parenteral nutrition

Cost‐effectiveness of taurolidine‐citrate in a cohort of patients with intestinal failure receiving home parenteral nutrition

Central Catheter‐related Bloodstream Infection Rates in Children on Home Parenteral Nutrition

Meta‐analysis of the efficacy of taurolidine in reducing catheter‐related bloodstream infections for patients receiving parenteral nutrition

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