Prevention of uncuffed hemodialysis catheter-related bacteremia using an antibiotic lock technique: A prospective, randomized clinical trial
- Authors
- Kim, SH; Song, KI; Chang, JW; Kim, SB; Sung, SA; Jo, SK; Cho, WY; Kim, HK
- Issue Date
- Jan-2006
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- antibiotic lock technique; uncuffed catheter; catheter-related bacteremia
- Citation
- KIDNEY INTERNATIONAL, v.69, no.1, pp 161 - 164
- Pages
- 4
- Indexed
- SCIE
SCOPUS
- Journal Title
- KIDNEY INTERNATIONAL
- Volume
- 69
- Number
- 1
- Start Page
- 161
- End Page
- 164
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/19064
- DOI
- 10.1038/sj.ki.5000012
- ISSN
- 0085-2538
1523-1755
- Abstract
- As a result of the high rate of infection, the NKF-K/DOQI guidelines recommended that an uncuffed catheter (UC) should not be used for longer than 3 weeks. However, the findings of the Dialysis Outcomes and Practice Patterns Study recognized that 48% of new hemodialysis patients in the US and 75% in Europe used UC for temporary access during arteriovenous fistula or graft maturation. The antibiotic lock technique (ALT) has been recommended to prevent catheter-related bacteremia (CRB). Here, we prospectively evaluated the efficacy of catheter-restricted filling using an antibiotic lock solution in preventing CRB. A total of 120 new hemodialysis patients requiring a temporary catheter while waiting for placement and maturation of an arteriovenous fistula or graft were enrolled in this study. Patients with a UC were randomly assigned to receive either an antibiotic heparin lock solution ( antibiotic group: cefazolin 10mg/ml, gentamicin 5mg/ml, heparin 1000U/ml) or a heparin lock solution (no-antibiotic group: heparin 1000U/ml) as a catheter lock solution during the interdialytic period. The end point of the trial was CRB. CRB developed in seven (11.7%) patients in the no-antibiotic group ( Staphylococcus aureus, two; Staphylococcus epidermidis, five) whereas only one patient in the antibiotic group had S. aureus bacteremia. CRB rates per 1000 catheter-days were 0.44 in the antibiotic group versus 3.12 in the no-antibiotic group (P = 0.031). Kaplan-Meier analysis also showed that mean CRB-free catheter survival of 59 days (95% CI, 58-61 days) in the antibiotic group was greater than that in the no-antibiotic group ( 55 days; 95% CI, 50-59 days). The results suggest that ALT may be a beneficial means of reducing the CRB rate in hemodialysis patients with UC.
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Collections - 2. Clinical Science > Department of Nephrology and Hypertension > 1. Journal Articles
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