Saving Infected Catheters: Why and How

Vol. 23, No. 1, 2005

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Paper

Saving Infected Catheters: Why and How
Michael Allon

Division of Nephrology, University of Alabama at Birmingham, Birmingham, Ala., USA

Address of Corresponding Author

Blood Purif 2005;23:23-28 (DOI: 10.1159/000082007)

Key Words

Infection
Bacteremia
Dialysis catheter
Vascular access
Antibiotic

Abstract

Conventional management of dialysis catheter-related bacteremia involves administration of systemic antibiotics, as well as removal of the infected catheter. This approach adds burdensome and expensive procedures, and creates short-term problems for dialysis access. Recent research has shown that bacterial biofilms form routinely in the catheter lumen, and act as the nidus for bacteremic episodes. Instillation of a concentrated antibiotic-anticoagulant solution into the catheter lumen ('antibiotic lock') may permit successful treatment of the infection, while salvaging the patient's catheter. A number of recent studies have reported the success of an antibiotic lock protocol in about two thirds of cases of catheter-related bacteremia. Catheter replacement is only performed in those patients with protocol failures (persistent fever or positive surveillance blood cultures). In conclusion, routine application of an antibiotic lock protocol may reduce substantially the need for routine catheter replacement in hemodialysis patients with catheter-related bacteremia.

Author Contacts

Michael Allon, MD
Division of Nephrology, PB, Room 226
1530 Third Ave., S
Birmingham, AL 35294 (USA)
Tel. +1 205 975 9676, Fax +1 205 975 8879, E-Mail mdallon@uab.edu

Article Information

Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 2, Number of References : 26

Medline Abstract (ID 15627733)

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