Document Detail


Prevention of intravascular catheter-related infection with newer chlorhexidine-silver sulfadiazine-coated catheters: a randomized controlled trial.
MedLine Citation:
PMID:  15060765     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The indication of antiseptic-coated catheters remains debated. OBJECTIVE: To test the ability of the new generation of chlorhexidine-silver and sulfadiazine-coated catheters, with enhanced antiseptic coating, to reduce the risk of central venous catheter (CVC)-related infection in ICU patients. DESIGN: Multicentre randomized double-blind trial. PATIENTS AND SETTING: A total of 397 patients from 14 ICUs of university hospitals in France. INTERVENTION: Patients were randomized to receive an antiseptic-coated catheter (ACC) or a standard non-coated catheter (NCC). MEASUREMENTS: Incidence of CVC-related infection. RESULTS: Of 367 patients having a successful catheter insertion, 363 were analysed (175 NCC and 188 ACC). Patients had one (NCC=162, ACC=180) or more (NCC=13, ACC=11) CVC inserted. The two groups were similar for insertion site [subclavian (64 vs 69)] or jugular (36 vs 31%)], and type of catheters (single-lumen 18 vs 18%; double-lumen 82 vs 82%), and mean (median) duration of catheterisation [12.0+/-11.7 (9) vs 10.5+/-8.8 (8) days in the NCC and ACC groups, respectively]. Significant colonisation of the catheter occurred in 23 (13.1%) and 7 (3.7%) patients, respectively, in the NCC and ACC groups (11 vs 3.6 per 1000 catheter-days; p=0.01); CVC-related infection (bloodstream infection) occurred in 10 (5) and 4 (3) patients in the NCC and CC groups, respectively (5.2 vs 2 per 1000 catheter days; p=0.10). CONCLUSIONS: In the context of a low baseline infection rate, ACC were associated with a significant reduction of catheter colonisation and a trend to reduction of infection episodes, but not of bloodstream infection.
Authors:
Christian Brun-Buisson; Françoise Doyon; Jean-Pierre Sollet; Jean-François Cochard; Yves Cohen; Gérard Nitenberg
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2004-04-02
Journal Detail:
Title:  Intensive care medicine     Volume:  30     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-05     Completed Date:  2004-09-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  837-43     Citation Subset:  IM    
Affiliation:
Réanimation Médicale, Hôpital Henri Mondor (AP-HP), Av du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France. christian.brun-buisson@hmn.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Anti-Infective Agents, Local / therapeutic use*
Bacteremia / etiology,  prevention & control*
Catheterization, Central Venous / adverse effects*
Chlorhexidine / therapeutic use*
Double-Blind Method
Equipment Contamination / prevention & control*
France
Humans
Intensive Care Units
Middle Aged
Severity of Illness Index
Silver Sulfadiazine / therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Infective Agents, Local; 22199-08-2/Silver Sulfadiazine; 55-56-1/Chlorhexidine

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


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