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Antibiotic-coated catheters and antiseptic-coated catheters are equally effective at preventing infection.
True—and False
In "Effect of a Second-Generation Venous Catheter Impregnated With Chlorhexidine and Silver Sulfadiazine on Central Catheter-Related Infections: A Randomized, Controlled Trial," Mark E. Rupp, MD, et al. noted:
"Although this was not a comparative trial with minocycline-rifampin-coated catheters, the colonization rates and infection observed in the patients in the antiseptic catheter group are similar to rates observed for patients with minocycline-rifampin catheters in two previously published studies (colonization was 8 percent and 7.9 percent; rate of bloodstream infection was 0 and 0.3 per 1,000 catheter days, respectively." (1)
One area where there's a clear difference in efficacy is breadth of protection. ARROWg+ard Blue PLUS® catheters are proven effective against the full spectrum of potential infection agents; there's no proof available that catheters coated with minocycline and rifampin have any impact at all against six strains of especially deadly and increasingly common pathogenic yeasts. These yeasts are responsible for the well-documented increase in fungal catheter-related infections.
Additionally, there may be a very real danger of encouraging antibiotic-resistant pathogens.
As noted in a 2001 article by Tambe et al., there is a real potential for resistance to occur when using the antibiotics minocycline and rifampin as an infection-protection technology compared with using the antimicrobial agents of chlorhexidine and silver sulfadiazine. (3)
REFERENCES:
(1) Rupp, M.E., Lisco, S.J., Lipsett, P.A., Perl, T.M., Keating, K., Civetta, J.M., Mermel, L.A., Lee, D., Dellinger, P.E., Donahue, M., Giles, D., Pfaller, M.A., Maki, D.G., Sherertz, R. “Effect of a Second-Generation Venous Catheter Impregnated With Chlorhexidine and Silver Sulfadiazine on Central Catheter-Related Infections: A Randomized, Controlled Trial.” Annals of Internal Medicine, Vol. 143, No. 8, October 18, 2005, pp. 570–581.
(2) Nguyen, M.H., Peacock, J.E. Jr., Tanner, D.C., Morris, A.J., Nguyen, M.L., Snydman, D.R., Wagener, M.M., Yu, V.L. “Therapeutic Approaches in Patients With Candidemia. Evaluation in a Multicenter, Prospective, Observational Study.” Archives of Internal Medicine, December 1995, Vol. 155, Issue 22, pp. 2429–2435.
(3) Sampath, L., Tambe, S., Modak, S. “Comparison of the Efficacy of Antimicrobial and Antibiotic Catheters Impregnated on Both Their Luminal and Outer Surfaces,” Presented at the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), San Francisco, CA, September 26–28, 1999.
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5 million lives campaign
The 5 Million Lives Campaign is a voluntary initiative to protect patients from five million incidents of medical harm over the next two years (December 2006 – December 2008).
- IHI 5 Million Lives Website
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- IHI Getting Started Kit: Prevent Ventilator-Associated Pneumonia How-to Guide
Center for Disease Control and Prevention (CDC)
Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee
