Document Detail

Bloodstream infections among patients treated with intravenous epoprostenol or intravenous treprostinil for pulmonary arterial hypertension--seven sites, United States, 2003-2006.
MedLine Citation:
PMID:  17332729     Owner:  NLM     Status:  MEDLINE    
Pulmonary arterial hypertension (PAH) is a life-threatening disorder characterized by elevated pulmonary artery pressure and pulmonary vascular resistance. Continuous infusion of a prostanoid, which acts as a vasodilator and anti-proliferative agent, is indicated in the treatment of patients with severe PAH. Two prostanoids are approved for intravenous (IV) use in the United States: epoprostenol (epoprostenol sodium [brand name Flolan], Gilead, Foster City, California) and treprostinil (treprostinil sodium [brand name Remodulin], United Therapeutics, Silver Spring, Maryland). These drugs are administered to PAH patients at hundreds of treatment centers in the United States. In September 2006, CDC received a report from a PAH specialist of a suspected increase in the number of gram-negative bloodstream infections (BSIs) among PAH patients treated with IV treprostinil. CDC conducted a retrospective investigation with the assistance of several state health departments and the cooperation of seven PAH treatment centers to determine the relative rates of BSI in a sample of patients treated with IV treprostinil and IV epoprostenol during 2003--2006. This report describes the results of that investigation, which indicated that, based on combined data from seven separate PAH treatment centers, pooled mean rates of BSI (primarily gram-negative BSI) were significantly higher for patients on treprostinil than for those on epoprostenol. The results do not suggest intrinsic contamination of IV treprostinil as a cause of the infections; the difference in rates might have been caused by differences in preparation and storage of the two agents, differences in catheter care practices, or differences in the anti-inflammatory activity of the agents. Health-care providers who care for PAH patients should be aware of these findings. Further investigation is needed to determine the causes of the different infection rates at centers where this was observed and to determine whether such a difference exists in other PAH treatment centers.
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  MMWR. Morbidity and mortality weekly report     Volume:  56     ISSN:  1545-861X     ISO Abbreviation:  MMWR Morb. Mortal. Wkly. Rep.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-02     Completed Date:  2007-03-02     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  7802429     Medline TA:  MMWR Morb Mortal Wkly Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  170-2     Citation Subset:  IM    
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MeSH Terms
Antihypertensive Agents / administration & dosage
Catheters, Indwelling / adverse effects
Drug Contamination
Epoprostenol / administration & dosage,  analogs & derivatives*
Hypertension, Pulmonary / drug therapy
Infection Control
Infusions, Intravenous* / adverse effects
Sepsis / epidemiology*,  etiology
United States / epidemiology
Reg. No./Substance:
0/Antihypertensive Agents; 0/treprostinil; 35121-78-9/Epoprostenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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