A systematic review comparing the relative effectiveness of antimicrobial-coated catheters in intensive care units

Ramritu, Prabha, Halton, Kate A., Collignon, Peter, Cook, David, Fraenkel, David, Battistutta, Diana, Whitby, Michael, & Graves, Nicholas (2008) A systematic review comparing the relative effectiveness of antimicrobial-coated catheters in intensive care units. American Journal of Infection Control, 36(2), pp. 104-117.

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Background: Bloodstream infection related to a central venous catheter is a substantial clinical and economic problem. To develop policy for managing the risks of these infections, all available evidence for prevention strategies should be synthesized and understood.-----

Methods: We evaluate evidence (1985-2006) for short-term antimicrobial-coated central venous catheters in lowering rates of catheter-related bloodstream infection (CRBSI) in the adult intensive care unit. Evidence was appraised for inclusion against predefined criteria. Data extraction was by 2 independent reviewers. Thirty-four studies were included in the review. Antiseptic, antibiotic, and heparin-coated catheters were compared with uncoated catheters and one another. Metaanalysis was used to generate summary relative risks for CRBSI and catheter colonization by antimicrobial coating.-----

Results: Externally impregnated chlorhexidine/silver sulfadiazine catheters reduce risk of CRBSI relative to uncoated catheters (RR, 0.66; 95% CI: 0.47-0.93). Minocycline and rifampicin-coated catheters are significantly more effective relative to CHG/SSD catheters (RR, 0.12; 95% CI: 0.02-0.67). The new generation chlorhexidine/silver sulfadiazine catheters and silver, platinum, and carboncoated catheters showed nonsignificant reductions in risk of CRBSI compared with uncoated catheters.-----

Conclusion: Two decades of evidence describe the effectiveness of antimicrobial catheters in preventing CRBSI and provide useful information about which catheters are most effective. Questions surrounding their routine use will require supplementation of this trial evidence with information from more diverse sources. (Am J Infect Control 2008;36:104-17.)

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ID Code: 19611
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Cross infection, Catheter - control venous, Intensive care, Nosocomial, Antimicrobial
DOI: 10.1016/j.ajic.2007.02.012
ISSN: 0196-6553
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL MICROBIOLOGY (110800) > Medical Infection Agents (incl. Prions) (110802)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Deposited On: 23 Apr 2009 05:47
Last Modified: 29 Feb 2012 13:49

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