A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group. Export

@article{citeulike:2954962, abstract = {BACKGROUND: The use of central venous catheters impregnated with either minocycline and rifampin or chlorhexidine and silver sulfadiazine reduces the rates of catheter colonization and catheter-related bloodstream infection as compared with the use of unimpregnated catheters. We compared the rates of catheter colonization and catheter-related bloodstream infection associated with these two kinds of antiinfective catheters. METHODS: We conducted a prospective, randomized clinical trial in 12 university-affiliated hospitals. High-risk adult patients in whom central venous catheters were expected to remain in place for three or more days were randomly assigned to undergo insertion of polyurethane, triple-lumen catheters impregnated with either minocycline and rifampin (on both the luminal and external surfaces) or chlorhexidine and silver sulfadiazine (on only the external surface). After their removal, the tips and subcutaneous segments of the catheters were cultured by both the roll-plate and the sonication methods. Peripheral-blood cultures were obtained if clinically indicated. RESULTS: Of 865 catheters inserted, 738 (85 percent) produced culture results that could be evaluated. The clinical characteristics of the patients and the risk factors for infection were similar in the two groups. Catheters impregnated with minocycline and rifampin were 1/3 as likely to be colonized as catheters impregnated with chlorhexidine and silver sulfadiazine (28 of 356 catheters [7.9 percent] vs. 87 of 382 [22.8 percent], P<0.001), and catheter-related bloodstream infection was 1/12 as likely in catheters impregnated with minocycline and rifampin (1 of 356 [0.3 percent], vs. 13 of 382 [3.4 percent] for those impregnated with chlorhexidine and silver sulfadiazine; P<0.002). CONCLUSIONS: The use of central venous catheters impregnated with minocycline and rifampin is associated with a lower rate of infection than the use of catheters impregnated with chlorhexidine and silver sulfadiazine.}, address = {Department of Medicine, Baylor College of Medicine and Veterans Affairs Medical Center, Houston, TX 77030, USA. Darouiche.Rabih.O@Houston.VA.Gov}, author = {Darouiche, R. O. and Raad, I. I. and Heard, S. O. and Thornby, J. I. and Wenker, O. C. and Gabrielli, A. and Berg, J. and Khardori, N. and Hanna, H. and Hachem, R. and Harris, R. L. and Mayhall, G.}, citeulike-article-id = {2954962}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/9878638}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=9878638}, day = {7}, issn = {0028-4793}, journal = {The New England journal of medicine}, keywords = {icu}, month = {January}, number = {1}, pages = {1--8}, posted-at = {2008-07-03 06:03:37}, priority = {2}, title = {A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/9878638}, volume = {340}, year = {1999} }

TY - JOUR ID - citeulike:2954962 L3 - citeulike-article-id:2954962 N2 - BACKGROUND: The use of central venous catheters impregnated with either minocycline and rifampin or chlorhexidine and silver sulfadiazine reduces the rates of catheter colonization and catheter-related bloodstream infection as compared with the use of unimpregnated catheters. We compared the rates of catheter colonization and catheter-related bloodstream infection associated with these two kinds of antiinfective catheters. METHODS: We conducted a prospective, randomized clinical trial in 12 university-affiliated hospitals. High-risk adult patients in whom central venous catheters were expected to remain in place for three or more days were randomly assigned to undergo insertion of polyurethane, triple-lumen catheters impregnated with either minocycline and rifampin (on both the luminal and external surfaces) or chlorhexidine and silver sulfadiazine (on only the external surface). After their removal, the tips and subcutaneous segments of the catheters were cultured by both the roll-plate and the sonication methods. Peripheral-blood cultures were obtained if clinically indicated. RESULTS: Of 865 catheters inserted, 738 (85 percent) produced culture results that could be evaluated. The clinical characteristics of the patients and the risk factors for infection were similar in the two groups. Catheters impregnated with minocycline and rifampin were 1/3 as likely to be colonized as catheters impregnated with chlorhexidine and silver sulfadiazine (28 of 356 catheters [7.9 percent] vs. 87 of 382 [22.8 percent], P<0.001), and catheter-related bloodstream infection was 1/12 as likely in catheters impregnated with minocycline and rifampin (1 of 356 [0.3 percent], vs. 13 of 382 [3.4 percent] for those impregnated with chlorhexidine and silver sulfadiazine; P<0.002). CONCLUSIONS: The use of central venous catheters impregnated with minocycline and rifampin is associated with a lower rate of infection than the use of catheters impregnated with chlorhexidine and silver sulfadiazine. IS - 1 JF - The New England journal of medicine SN - 0028-4793 AD - Department of Medicine, Baylor College of Medicine and Veterans Affairs Medical Center, Houston, TX 77030, USA. Darouiche.Rabih.O@Houston.VA.Gov EP - 8 TI - A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group. VL - 340 SP - 1 KW - icu AU - Darouiche, RO AU - Raad, II AU - Heard, SO AU - Thornby, JI AU - Wenker, OC AU - Gabrielli, A AU - Berg, J AU - Khardori, N AU - Hanna, H AU - Hachem, R AU - Harris, RL AU - Mayhall, G PY - 1999/01/07/ UR - http://view.ncbi.nlm.nih.gov/pubmed/9878638 ER -