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Successful Prevention of Tunneled, Central Catheter Infection by Antibiotic Lock Therapy Using Cefotaxime



Mortazavi M1 ; Alsaeidi S1 ; Sobhani R2 ; Salimic F3 ; Atapour A1 ; Sharif N4 ; Akbari M1 ; Pakzad B1 ; Jazi AHD5
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Authors Affiliations
  1. 1. Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Gonabad University of Medical Sciences, Mashhad, Iran
  3. 3. Department of Vascular Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. School of Medicine, Ross University, United States
  5. 5. Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Research in Medical Sciences Published:2011

Abstract

BACKGROUND: Chronic hemodialysis patients frequently require vascular access through central venous catheters (CVCs). The most significant complication of these catheters is infection. This risk can be lowered by the use of an antibiotic-Heparin lock. This study focuses on hemodialysis patients using Tunneled-cuffed catheters (TCC), to assess the rate of catheter-related infections (CRI) in catheter-restricted filling with Cefotaxime and Heparin in end stage renal disease patients. METHODS: A double-blind randomized study was conducted to compare 5000 U/ml Heparin plus10 mg/ml cefotaxime (CE/HS) as catheter-lock solutions, with Heparin (5000 U/ml) alone. A total of 30 patients with end-stage renal disease and different etiologies, were enrolled for chronic hemodialysis with permanent catheters from December 2009 to March 2010. These patients were randomly assigned to two groups of 15 members. Blood samples were collected for culture, sensitivity, and colony count, from the catheter lumen and the peripheral vein. CRI was considered as the end point. RESULTS: The rate of CRI was significantly lower in the cefotaxime group versus control group (p < 0.001). No exit site infection was occurred in both groups. Infection-free survival rates at 180 days were 100% for the CE/HS group, and 56% for the HS group. CONCLUSIONS: Antibiotic lock therapy using cefotaxime reduces the risk of CRI in hemodialysis patients.
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