Benefits of minocycline and rifampin-impregnated central venous catheters |
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Authors: | Cristóbal?León author-information" > author-information__contact u-icon-before" > mailto:cleong@infonegocio.com" title=" cleong@infonegocio.com" itemprop=" email" data-track=" click" data-track-action=" Email author" data-track-label=" " >Email author,Sergio?Ruiz-Santana,Jordi?Rello,Maria?V.?de la?Torre,Jordi?Vallés,Francisco?álvarez-Lerma,Rafael?Sierra,Pedro?Saavedra,Francisco?álvarez-Salgado,for the Caba?a Study Group |
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Affiliation: | (1) Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Carretera de Cádiz s/n, 41014 Sevilla, Spain;(2) Intensive Care Unit, Hospital Universitario Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain;(3) Intensive Care Unit, Hospital Universitari Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain;(4) Intensive Care Unit, Hospital Ntra. Sra. de la Victoria, Málaga, Spain;(5) Intensive Care Unit, Hospital Parc Taulí, Sabadell, Barcelona, Spain;(6) Intensive Care Unit, Hospital Universitari del Mar , Universitat Autònoma de Barcelona, Barcelona, Spain;(7) Intensive Care Unit, Hospital Universitario Puerta del Mar, Universidad de Cádiz, Cádiz, Spain;(8) Mathematics Department, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain |
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Abstract: | Objective To determine the efficacy of minocycline and rifampin-impregnated catheters compared to non-impregnated catheters in critically ill patients.Design Prospective, randomized, double-blind, controlled, multicenter trial.Setting Intensive care units of seven acute-care teaching hospitals in Spain.Patients Intensive care unit patients requiring triple-lumen central venous catheter for more than 3 days.Interventions At catheter insertion, 228 patients were randomized to minocycline and rifampin-impregnated catheters and 237 to non-impregnated catheters. Skin, catheter tip, subcutaneous segment, hub cultures, peripheral blood and infusate cultures were performed at catheter withdrawal. The rate of colonization, catheter-related bloodstream infection (CRBSI) and catheter-related clinical infectious complications (purulence at the insertion site or CRBSI) were assessed.Measurements and main results In the intention-to-treat analysis (primary analysis), the episodes per 1000 catheter days of clinical infectious complications decreased from 8.6 to 5.7 (RR =0.67, 95% CI 0.31–1.44), CRBSI from 5.9 to 3.1 (RR =0.53, 95% CI 0.2–1.44) and tip colonization from 24 to 10.4 (RR =0.43, 95% CI 0.26–0.73). Antimicrobial-impregnated catheters were associated with a significant decrease of coagulase-negative staphylococci colonization (RR =0.24, 95% CI 0.13–0.45) and a significant increase of Candida spp. colonization (RR =5.84, 95% CI 1.31–26.1).Conclusions The use of antimicrobial-impregnated catheters was associated with a significantly lower rate of coagulase-negative staphylococci colonization and a significant increase in Candida spp. colonization, although a decrease in CRBSI, increase in 30-day survival or reduced length of stay was not observed.Electronic Supplementary Material Supplementary material is available in the online version of this article at http://dx.doi.org/10.1007/s00134-004-2378-2This study was supported by a grant from Cook Europe. |
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Keywords: | Central venous catheters Minocycline and rifampin-impregnated catheters Non-impregnated catheters Rate of colonization Bloodstream infection Clinical infectious complications |
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