ln-vitro-Wirksamkeit von Taurolidin und 9 Antibiotika gegen klinische Isolate aus chirurgischem Einsendegut sowie gegen Pilze

Nösner, K.; Focht, Josef

doi:10.1159/000178454

Cited by 10 publications

(7 citation statements)

References 2 publications

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“…Taurolidine, a substance that has been used in Europe since the 1970s as an antimicrobial lavage treating peritonitis and a variety of types of wounds, has been used as a locking solution along with sodium citrate to provide anticoagulation (85–88). This antimicrobial agent has been found to be effective against a broad range of gram‐negative and gram‐positive bacteria as well as many types of fungi (89,90). Taurolidine appears to be effective and safe and does not appear to carry the risk for side effects that have been reported for some antibiotic lock solutions.…”

Section: Prophylaxismentioning

confidence: 99%

Infection Associated with Tunneled Hemodialysis Catheters

Beathard¹,

Urbanes²

2008

Seminars in Dialysis

108

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The use of tunneled dialysis catheters to deliver hemodialysis treatment may be associated with major problems. For this reason their use should be minimized as much as possible. Infection is the most serious of these problems. This complication causes very significant morbidity and mortality and has emerged as the primary barrier to long-term catheter use. Bacteremia is the most serious type of infection associated with catheter use. It can result in metastatic infection and even lead to death of the patient. Prophylaxis is important to decrease the risk of infection. The use of an antibiotic ointment at the exit site until it has healed and the long-term use of a dressing to cover the exit site are effective in decreasing the incidence of exit-site infection. With optimal catheter-use management, it should be possible to reduce the incidence of catheter-related bacteremia (CRB) to a level in the range of 1 ⁄ 1000 catheter days. Antibiotic and antimicrobial locking solutions show promise and may, if verified in appropriate clinical studies, prove to be important adjuncts to the management of catheterdependent patients. Aspirin has been shown to have anti-staphylococcal activity and warrants further clinical evaluation. The diagnosis of CRB is based upon positive blood cultures in association with typical clinical features. If a simple routine blood culture is positive, along with a high clinical probability based upon the patient's signs and symptoms, the sensitivity and specificity of the diagnosis is greater than 75%. CRB is in reality a biofilm infection and must be treated as such. Treatment needs to focus on appropriate systemic antibiotics which should be continued for a minimum of 3 weeks and catheter management to remove the biofilm. Catheter exchange has been shown to be effective and should be performed based upon the clinical presentation of the patient. While treatment with a combination of systemic antibiotics and antibiotic locking solution may be effective for gramnegative infections, this approach does not appear to be a good choice for Staphylococcus aureus CRB.The use of a tunneled dialysis catheter (TDC) to deliver hemodialysis (HD) treatment may be associated with major problems. Catheter dysfunction (inadequate flow) secondary to thrombosis and catheter-related infections are common occurrences. Although catheter dysfunction is the more common of the two complications, infection related to the use of a catheter is the more serious problem, representing a very significant cause of morbidity and mortality and has emerged as the primary barrier to long-term catheter use. The overall incidence of this problem can be appreciated from a review of the data generated by the HEMO study. This was a study of 1846 randomized HD patients designed primarily to evaluate the efficiency of dialysis, but secondarily also evaluated infection-related deaths and first infectionrelated hospitalizations. Catheters were present in 32% of all study patients admitted with access-related infection, even thoug...

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Section: Prophylaxismentioning

confidence: 99%

Infection Associated with Tunneled Hemodialysis Catheters

Beathard¹,

Urbanes²

2008

Seminars in Dialysis

108

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“…LOCK IT-100 trial [31][32][33][34] LOCK IT-100 was a large, randomized, double-blind, active-control, multicenter, phase 3 study (Table 2). 66 Adult patients with kidney failure receiving hemodialysis through permanent tunneled cuffed catheter were randomized in 1:1 ratio to either taurolidine and heparin or heparin.…”

Section: Discussionmentioning

confidence: 99%

“…Winniki study [31][32][33][34] This is a prospective, multicenter, randomized, controlled trial, comparing 2 lock solutions (taurolidine vs. citrate) (Table 2). 67 In the taurolidine group, TauroLock-Hep500 twice per week and TauroLock-U25,000 once a week were used, and citrate 4% was used after each dialysis.…”

Section: Discussionmentioning

confidence: 99%

“…Murray study [31][32][33][34] In this large, observational, hemodialysis cohort, lock therapy with taurolidine 1.35%, citrate 4%, and heparin 500 units/mL (taurolidine-citrate-heparin) was compared with a retrospective cohort of patients given heparin 5000 units/mL for TCVC lock, assessing the impact on the rates of staphylococcal BSI (Table 2). 69 Following conversion to taurolidine-citrate-heparin, the rate ratio of staphylococcal bacteremic events in the TCVC group was 0.42 (95% CI 0.35, 0.50, P , 0.01) over the observation period.…”

Section: Discussionmentioning

confidence: 99%

“…Summary of taurolidine in vitro activity against various pathogenic microbes reported in the literature [31][32][33][34]. …”

mentioning

confidence: 99%

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Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis

Nguyen,

Camins,

Butler

2024

American Journal of Therapeutics

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Background: Chronic kidney disease can lead to end-stage renal disease, and the prevalence is increasing. Many patients starting hemodialysis require central venous catheters (CVCs). Catheter-related bloodstream infections (CRBSIs) are a common complication and lead to significant morbidity and mortality. Interventions to prevent CRBSI include antimicrobial lock therapy but concern for the development of antimicrobial resistance and adverse effects. Nonantimicrobial antiseptics as catheter lock solutions have also been used. Taurolidine and heparin catheter lock solution is first approved by the Food and Drug Administration for the prevention of CRBSI in patients on hemodialysis. Taurolidine has a unique mechanism of action and favorable safety profile. Mechanism of Action, Pharmacodynamics, and Pharmacokinetics: Taurolidine and heparin catheter lock solution have both antimicrobial and anticoagulant properties. Taurolidine is derivative of the amino acid taurine, and heparin is derived from porcine intestinal mucosa. Taurolidine not only damages microbial cell walls but also prevents the adherence of microorganisms to biological surfaces, preventing biofilm formation. Taurolidine and heparin catheter lock solution is intended to be used intraluminally within the catheter and should be aspirated. Because it is used locally, limited pharmacokinetic and pharmacodynamic data are available. Clinical Trials: The LOCK-IT-100 trial is a randomized, double-blind, phase 3 study, which included 795 end-stage renal disease patients on hemodialysis with CVC. Taurolidine and heparin was compared with the control heparin alone. The results of the study showed a 71% risk reduction in CRBSI for taurolidine and heparin arm (95% confident interval, 38%–86%, P = 0.0006). Other studies have also shown that taurolidine lock solution leads to decreased CRBSI episodes. Several systematic reviews and meta-analysis consisted of taurolidine in adult, and pediatric populations also showed reduction in the incidence of CRBSIs. Therapeutic Advance: Taurolidine and heparin lock solution represents a novel preventive strategy for those undergoing hemodialysis through a CVC by reducing the risk of CRBSI. This is significant progress because there are no other similar options available for patients for whom catheters are the only options for their life-saving treatment.

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Erregerhäufigkeit und Resistenzsituation bei Peritonitis 1996

Focht

Nösner

1997

Langenbecks Arch Chir

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Severe intra-abdominal infection is associated with a high mortality rate. In addition to risk factors in the patients, the causal pathogens and the selection of appropriate therapeutic procedures play an essential part in the course of these conditions. In the majority of intra-abdominal infections mixed aerobic/anaerobic infections, mostly with some involvement of enterobacteria and also of enterococci and staphylococci can be demonstrated. In addition to surgical intervention a calculated antimicrobial initial treatment of intra-abdominal infections with an antibiotic with an adequate effect to combat the pathogen concerned can contribute to improving the patient's prognosis. A calculated antibiotic treatment can only be effectively and reliably carried through if the frequency of the pathogen and the resistance situation are known. Retrospective evaluations of data on the sensitivity and frequency of pathogens from a defined group of subjects allow conclusions on the epidemiological situation in a particular catchment area or in a medical sector and thus make it possible to calculate the appropriate therapy for infections. In 1996 a total of 2,779 bacterial isolates from the intra-abdominal infection sector were examined: 935 Enterobacteriaceae, 83 nonfermenters, 177 Staphylococcus spp., 211 Enterococcus spp., 39 Streptococcus spp., and 1334 different anaerobic bacteria. Fresh clinical isolates were available for all pathogens tested. The most frequent gram-negative pathogen was E. coli (60%) and the most frequent gram-positive pathogen, E. faecalis (44%); the most frequent anaerobic pathogen was B. fragilis (39%). Taurolodine had the lowest resistance rate against gram-negative and anaerobic pathogens. Teicoplanin had the highest activity against gram-positive pathogens.

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ln-vitro-Wirksamkeit von Taurolidin und 9 Antibiotika gegen klinische Isolate aus chirurgischem Einsendegut sowie gegen Pilze

Cited by 10 publications

References 2 publications

Infection Associated with Tunneled Hemodialysis Catheters

Infection Associated with Tunneled Hemodialysis Catheters

Taurolidine and Heparin as Catheter Lock Solution for Central Venous Catheters in Hemodialysis

Erregerhäufigkeit und Resistenzsituation bei Peritonitis 1996

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