Ethanol Locks in the Prevention and Treatment of Catheter-Related Bloodstream Infections

Abstract

The current literature suggests that prophylactic ELT decreases the rates of infection and catheter removal, and ELT treatment appears efficacious in combination with systemic antibiotics.

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

“…In an experimental model of plastic‐adherent biofilm, a 4‐hour exposure to a concentration of 70% ethanol was shown to be bactericidal and fungicidal by diffusing through the polysaccharide matrix of the biofilm and causing denaturation of the cell membrane 6 , 21 . Our findings are in agreement with previously published studies with similar reductions in CRBSIs and related CVC‐Rs in both our total (ELT − vs ELT + ) and paired cohorts (pre‐ELT vs ELT) 1 , 10 , 16 . ‐ 18 , 22 Differences in the mean rates of CRBSIs did not reach significant levels, probably due to low CRBSI rates in individual patients in both groups, as evidenced from the median values (Tables 1 and 2), which are lower than previously reported 1 , 16 …”

“…Instillation of 70% ethanol into the lumen of the CVC with a dwell time ranging from 2 hours to as long as PN is cycled off, performed anywhere from once a week to daily as “ethanol lock therapy,” is being used by increasing numbers of intestinal rehabilitation programs due to encouraging reports of resulting reduction in rates of CRBSI and related CVC‐Rs 6 , 9 . ‐ 11 , 17 ‐ 19 In addition to being inexpensive, ethanol is not known to create any bacterial resistance, making it an ideal agent for catheter lock therapy 20 . In an experimental model of plastic‐adherent biofilm, a 4‐hour exposure to a concentration of 70% ethanol was shown to be bactericidal and fungicidal by diffusing through the polysaccharide matrix of the biofilm and causing denaturation of the cell membrane 6 , 21 .…”

Epidemiology and Risk Factors for Outpatient‐Acquired Catheter‐Related Bloodstream Infections in Children Receiving Home Parenteral Nutrition

“…Additionally, use of ethanol locks to reduce the risk of CRBSIs should be considered. This practice has been found to be effective in both adult and pediatric populations …”

Efficacy in the Reduction of Central Line-Associated Bloodstream Infection in a Patient With Intestinal Failure: An Ethanol Lock Pediatric Case Study

“…2 An antimicrobial solution demonstrating promising outcomes for patients with IF requiring parenteral nutrition is the use of ethanol lock therapy. Clinical research studies demonstrate a reduction in CLABSI and line removal in 3,4,[6][7][8][9][10][11] Ethanol lock therapy is the instillation of medical-grade ethanol into a CVC that remains in the catheter to dwell for a prescribed time period.…”