BACKGROUND: Catheter-related infection (CRI) is associated with increased all-cause mortality and morbidity in hemodialysis patients and may be reduced by using antimicrobial lock solutions. But the safety of long-term use of antimicrobial lock still needs to be defined. METHODS:Patients with a new inserted permanent tunneled cuffed hemodialysis catheter were randomly assigned to an antibiotic lock solution of gentamicin (4 mg/ml) heparin (G group) or heparin alone (H group). RESULTS: A total of 140 patients were enrolled in this study. CRI rates were 0.06/1,000 catheter-days for the G group versus 0.67 in the H group (p = 0.014). The risk of CRI was 10.54 higher in patients with a heparin-alone locked catheter (p = 0.025) than that with gentamicin. The serum-measured gentamicin levels were very low. CONCLUSIONS:Gentamicin lock solution reduces CRI and improves catheter survival rates in hemodialysis patients. It is relatively safe in strictly catheter-restricted antibiotic lock solution therapy.
RCT Entities:
BACKGROUND: Catheter-related infection (CRI) is associated with increased all-cause mortality and morbidity in hemodialysis patients and may be reduced by using antimicrobial lock solutions. But the safety of long-term use of antimicrobial lock still needs to be defined. METHODS:Patients with a new inserted permanent tunneled cuffed hemodialysis catheter were randomly assigned to an antibiotic lock solution of gentamicin (4 mg/ml) heparin (G group) or heparin alone (H group). RESULTS: A total of 140 patients were enrolled in this study. CRI rates were 0.06/1,000 catheter-days for the G group versus 0.67 in the H group (p = 0.014). The risk of CRI was 10.54 higher in patients with a heparin-alone locked catheter (p = 0.025) than that with gentamicin. The serum-measured gentamicin levels were very low. CONCLUSIONS:Gentamicin lock solution reduces CRI and improves catheter survival rates in hemodialysis patients. It is relatively safe in strictly catheter-restricted antibiotic lock solution therapy.
Authors: Daniel L Landry; Gregory L Braden; Stephen L Gobeille; Sarah D Haessler; Chirag K Vaidya; Stephen J Sweet Journal: Clin J Am Soc Nephrol Date: 2010-07-01 Impact factor: 8.237
Authors: Maria C Arechabala; Maria I Catoni; Juan Carlos Claro; Noelia P Rojas; Miriam E Rubio; Mario A Calvo; Luz M Letelier Journal: Cochrane Database Syst Rev Date: 2018-04-03