Document Detail


The efficacy of prophylactic antibiotics administration prior to insertion of tunneled catheter in hemodialysis patients.
MedLine Citation:
PMID:  22880805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM AND BACKGROUND: Central venous catheter (CVC)-related blood stream infection is a major cause of morbidity and mortality in patients with end-stage renal diseases. However, CVCs are quite frequently required for vascular access in hemodialysis (HD) patients. Tunneled catheters (TCs) are widely used when a catheter is needed for a long period. However, long-term catheter survival is limited by TC-related infections. The purpose of this prospective study was to assess clinical outcomes of prophylactic antibiotics administration prior to insertion of TCs in HD patients.
MATERIAL AND METHODS: Sixty uremic patients who required TC insertion due to vascular access failure were included in our study between April 2009 and April 2010. Patients were randomized into two groups: group I and group II. Group I received 1 g of cefazolin sodium intravenously 1 h prior to catheter insertion. Group II received equal amount of saline intravenously 1 h prior to catheter insertion. The primary end points of the study were catheter loss, hospitalization, or mortality due to catheter-related infections (CRIs). The secondary end points included exit-site infection (not requiring hospitalization), tunnel infections (not requiring catheter removal), and bacteremia.
RESULTS: During the follow-up period, one patient in group I and three patients in group II reached primary end point (p < 0.05). Catheter loss due to infection was higher in group II than in group I as 6 versus 3, respectively (p < 0.05). Catheter exit-site infections, which does not require hospitalization, have been considered as secondary end points and have been detected in four patients for 7 times in group I and in six patients for 10 times in group II (p < 0.05). Tunnel infection, which does not require removal of the catheter, has been detected in two patients for 3 times in group I and in five patients for 6 times in group II (p < 0.05).
CONCLUSION: The prophylactic antibiotic use prior to TC insertion significantly reduced CRIs, bacteremia, and catheter loss.
Authors:
Bülent Huddam; Alper Azak; Gülay Koçak; Levent Ortabozkoyun; Murat Duranay
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Renal failure     Volume:  34     ISSN:  1525-6049     ISO Abbreviation:  Ren Fail     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-13     Completed Date:  2013-06-12     Revised Date:  2013-07-26    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  England    
Other Details:
Languages:  eng     Pagination:  998-1001     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Ankara Education and Research Hospital, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Antibiotic Prophylaxis*
Catheter-Related Infections / prevention & control*
Catheterization, Central Venous / adverse effects*,  methods
Catheters, Indwelling / adverse effects*
Cefazolin / therapeutic use*
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic / drug therapy,  therapy*
Male
Middle Aged
Prospective Studies
Renal Dialysis / instrumentation
Treatment Outcome
Chemical
Reg. No./Substance:
25953-19-9/Cefazolin

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


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