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A Randomized, Controlled Trial of a New Vascular Catheter Flush Solution (Minocycline-EDTA) in Temporary Hemodialysis Access

Published online by Cambridge University Press:  21 June 2016

Anthony J. Bleyer ,
Lori Mason ,
Gregory Russell ,
Issam I. Raad  and
Robert J. Sherertz
Anthony J. Bleyer*
Affiliation:
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Lori Mason
Affiliation:
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Gregory Russell
Affiliation:
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Issam I. Raad
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, Texas
Robert J. Sherertz
Affiliation:
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
*
Section on Nephrology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157.[email protected]
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Abstract

Background and Objective:

We previously demonstrated that minocycline-EDTA was efficacious at preventing catheter-related bloodstream infections (BSIs) in three patients with recurrent infections. This study compared heparin with minocycline-EDTA as flush solutions used among dialysis patients with central venous catheters, a high-risk group for catheter-related BSI.

Methods:

Patients were enrolled within 72 hours of catheter insertion and randomized to receive heparin or minocycline-EDTA as a flush after each dialysis session. Each syringe containing flush solution was wrapped in orange plastic to conceal the type of solution it contained. Patients were observed for evidence of infection and catheter thrombosis. After catheters were removed, cultures were performed to determine whether microbial colonization had occurred.

Results:

During a 14-month period, 60 patients were enrolled (30 in each group). The two groups had similar demographics and underlying diseases. Catheter survival at 90 days was 83% for the minocycline-EDTA group versus 66% for the heparin group (P = .07). Significant catheter colonization, a surrogate measure of catheter-related infection, was significantly more frequent in the heparin group (9 of 14 vs 1 of 11; P= .005). There was only one catheter-related bacteremia and it occurred in the heparin group.

Conclusions:

When compared with heparin, minocycline-EDTA had a better 90-day catheter survival (P = .07) and a decreased rate of catheter colonization. This pilot study warrants a larger prospective, randomized trial (Infect Control Hosp Epidemiol 2005;26:520-524).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 6 , June 2005 , pp. 520 - 524
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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