Antibiotic lock treatment of catheter-related sepsis
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2007, Vol 24, Issue 4
Abstract
The diagnosis of catheter-related infection (CRI) is based on the presence of clinical manifestations of infection and the evidence of colonization of the catheter tip by microbes. To confirm colonization, a number of procedures are used. Conventional management of CRI involves decisions regarding the necessity of the removal of the catheter and the administration of antibiotics. This is a review of the diagnosis and conventional management of CRI, with the indications and the clinical experience with the antibiotic lock treatment (ALT) to date. ALT is recommended particularly for treatment of intraluminal origin noncomplicated central venous CRI and has been performed in patients with various diseases (AIDS, cancer) or conditions (parenteral nutrition, dialysis). Overall, therapeutic success with central venous catheter salvage has been achieved in 112 (86%) of 130 episodes of bacterial sepsis. ALT is also indicated for chamber infections (whether or not they are associated with bacteremia) and it can prevent catheter-related bacteremia in cancer patients. ALT must be avoided for the treatment of complicated CRI, as well as in cases with evidence of extraluminal infection (inflammation over the tunnel or exit site or pocket of a totally implanted port). The majority of failures have been observed in cases of intraluminal origin catheter-related Candida infections. In catheter-related bloodstream infections due to Staphylococcus aureus, the catheter should be removed immediately because of the high risk of metastatic infection and increased mortality, and the S. aureus infections should be treated with appropriate antibiotics given intravenously. Antibiotic solution containing the desired antimicrobial agent in a suitable concentration (100-1000 times greater than the peak serum inhibitory concentrations achieved by conventional dosage of the corresponding systemic antibiotic) is usually mixed with 50-100 IU of heparin (or normal saline) in sufficient (usually 2-5 mL) volume. The antibiotic solution is installed in the catheter lumen during periods (usually 8-12 hours) when the catheter is not being used. The installed antibiotic is removed before infusion of the next dose of antibiotic or intravenous medication. The duration of ALT is most often 2 weeks.
Authors and Affiliations
G. Christakis, I. Chalkiopoulou
Keywords
Related Articles
- EP ID EP139235
- DOI -
- Views 65
- Downloads 0
Cost- and time-effectiveness of application of MALDI-TOF mass spectrometry methodology in a food and water microbiology laboratory
No abstract available
Criteria and processes for evaluating qualitative research methodology in health studies
In the field of health sciences, only during the last decades has there been a growing interest in the applicability of qualitative research methodology. Concurrently, a debate began about the scientific value of qualit...
Psychometric evaluation and normative data for the Greek SF-36 health survey<br /> using a large urban population sample <br /> <br />
OBJECTIVE To validate the Greek SF-36 health survey and to provide general population normative data. METHOD The survey was administered to a stratified representative sample (n=1426) of the general population residi...
The use of immunocytochemistry in the diagnosis of secondary central nervous system lymphoma
Central nervous system involvement, a well recognized complication of aggressive non-Hodgkin's lymphoma (NHL), has been rarely reported in indolent lymphomas. The case is reported of a 67 year-old male patient with folli...
Μοριακή μελέτη και πρόληψη κυστικής ίνωσης στον ελληνικό πληθυσμό
ΣΚΟΠΟΣ Έγινε χαρακτηρισμός του φάσματος και της συχνότητας των μεταλλάξεων στους Έλληνες ασθενείς με κυστική ίνωση (ΚΙ) και στις μονοσυμπτωματικές μορφές της νόσου, με σκοπό το σχεδιασμό προγραμμάτων πρόληψης για τον εντ...