Role of antibiotic prophylaxis for the prevention of intravascular catheter-related infection

Abstract

Intravascular catheters have become essential tools for the management of patients in modern medical practice, but there are complications. In particular, catheter-related infection remains a major cause of nosocomial infection and primary septicemia. The development of preventive strategies to reduce the incidence of catheter-related infection is an important goal for all health providers. Over recent years, significant advances in prophylactic measures for the prevention of catheter-related infection have been made. This paper reviews strategies based on antibiotic prophylaxis such as systemic administration of antibiotics, application of antibiotic ointments to the skin insertion site as well as catheter flushing with antibiotics, the antibiotic-lock technique and the use of antimicrobial impregnated catheters.

Use of Vancomycin-Containing Lock or Flush Solutions for Prevention of Bloodstream Infection Associated with Central Venous Access Devices: A Meta-Analysis of Prospective, Randomized Trials

“…Our search yielded 63 published reports (figure 1); 56 studies were excluded because they evaluated lock solutions other than vancomycin [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46], did not have a control group [47][48][49][50], used a lock solution for treatment rather than prevention [45,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65], did not use a randomized, controlled study design [66][67][68][69], assessed the utility of a lock solution for prevention of BSI with only 1 type of organism [70], were reviews [19,20,56,[71][72][73][74][75]...…”

“…A promising approach to preventing these infections has involved instilling (i.e., locking) an antiinfective solution into the device lumen or lumens to prevent colonization of the intraluminal surface by suspended planktonic-phase contaminants [19][20][21]. Because the majority of BSIs associated with IVDs are caused by gram-positive organisms, particularly coagulase-negative staphylococci [22][23][24][25], vancomycin in combination with heparin has been the best studied prophylactic lock solution.…”

Infectious Complication in 314 Patients after High-Dose Therapy and Autologous Hematopoietic Stem Cell Transplantation: Risk Factors Analysis and Outcome

“…With respect to these observations, the use of current sterile barriers seems to be insufficient. Among different strategies for the prevention of CVC-related infection, use of antimicrobial impregnated catheters is considered [23]. A metaanalysis of studies concerning impregnated catheters has found a significant reduction in the incidence of CVCrelated infection with the use of coated catheters in intensive care unit patients [24].…”

The use of in-line intravenous filters in sick newborn infants

“…Recent studies have shown contamination rates of 28.8% and 52% without the use of antibiotics (19,21) and of 13.3% with antibiotic prophylaxis (21). Antibiotic prophylaxis, although effective, may lead to resistance among coagulase-negative staphylococci (22). In a meta-analysis on the use of antimicrobial impregnated catheters in adults, a decrease in catheterrelated bacteraemia of 2.2% was found; however, again the risk of antimicrobial resistance was emphasized (22).…”