Antibiotic lock for treatment of tunneled hemodialysis catheter bacteremia.

Catheter-related bacteremia is a major cause of morbidity and mortality among catheter-dependent hemodialysis patients. Microorganism biofilm matrix formation in the catheter is the pathogenic process of this entity. Administration of systemic antibiotics and removal of the offending catheter is the most logical treatment. This article discusses an alternative option, instillation of an antibiotic-lock solution into the lumen of the catheter plus systemic antibiotic therapy. Recent studies suggest that this strategy could treat the infection and salvage the catheter, thus avoiding the need for further interventional procedures including but not limited to the removal of the catheter, placement of a temporary catheter, and finally placement of a new permanent catheter. The implementation of this effective approach will reduce morbidity and possibly reduce the cost and interventions associated with it.