Management of Hickman catheter sepsis.

Hickman catheters have been shown to be efficacious and durable. We believe their performance can be safely prolonged with aggressive management of complications. One hundred sixty-five consecutive patients with catheters were followed prospectively and 28 episodes of sepsis in 24 patients were evaluated. At least 90 percent of septic catheters were salvaged with a combination of antibiotics and thrombolytic agents. When our protocol was followed, all episodes of sepsis were successfully treated. This included gram-positive and gram-negative organisms as well as one case of fungal sepsis. Since treatment can be handled mostly on an outpatient basis, there are benefits in regard to patient comfort as well as health care costs.