Successful prevention of cuffed hemodialysis catheter-related infection using an antibiotic lock technique by strictly catheter-restricted antibiotic lock solution method

Blood Purif. 2009;27(2):206-11. doi: 10.1159/000197560. Epub 2009 Jan 29.

Abstract

Background: Catheter-related infection (CRI) is associated with increased all-cause mortality and morbidity in hemodialysis patients and may be reduced by using antimicrobial lock solutions. But the safety of long-term use of antimicrobial lock still needs to be defined.

Methods: Patients with a new inserted permanent tunneled cuffed hemodialysis catheter were randomly assigned to an antibiotic lock solution of gentamicin (4 mg/ml) heparin (G group) or heparin alone (H group).

Results: A total of 140 patients were enrolled in this study. CRI rates were 0.06/1,000 catheter-days for the G group versus 0.67 in the H group (p = 0.014). The risk of CRI was 10.54 higher in patients with a heparin-alone locked catheter (p = 0.025) than that with gentamicin. The serum-measured gentamicin levels were very low.

Conclusions: Gentamicin lock solution reduces CRI and improves catheter survival rates in hemodialysis patients. It is relatively safe in strictly catheter-restricted antibiotic lock solution therapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Catheter-Related Infections / prevention & control*
  • Catheters, Indwelling / adverse effects*
  • Female
  • Gentamicins / administration & dosage*
  • Gentamicins / blood
  • Heparin / administration & dosage*
  • Humans
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Renal Dialysis / adverse effects
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*

Substances

  • Gentamicins
  • Heparin