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- Title
Prevention of intravascular catheter-related infection with newer chlorhexidine-silver sulfadiazine-coated catheters: a randomized controlled trial.
- Authors
Brun-Buisson, Christian; Doyon, Françoise; Sollet, Jean-Pierre; Cochard, Jean-François; Cohen, Yves; xE9;rard#Nitenberg, G&; Doyon, Françoise; Cochard, Jean-François; Nitenberg, Gérard
- Abstract
<bold>Background: </bold>The indication of antiseptic-coated catheters remains debated.<bold>Objective: </bold>To test the ability of the new generation of chlorhexidine-silver and sulfadiazine-coated catheters, with enhanced antiseptic coating, to reduce the risk of central venous catheter (CVC)-related infection in ICU patients.<bold>Design: </bold>Multicentre randomized double-blind trial.<bold>Patients and Setting: </bold>A total of 397 patients from 14 ICUs of university hospitals in France.<bold>Intervention: </bold>Patients were randomized to receive an antiseptic-coated catheter (ACC) or a standard non-coated catheter (NCC).<bold>Measurements: </bold>Incidence of CVC-related infection.<bold>Results: </bold>Of 367 patients having a successful catheter insertion, 363 were analysed (175 NCC and 188 ACC). Patients had one (NCC=162, ACC=180) or more (NCC=13, ACC=11) CVC inserted. The two groups were similar for insertion site [subclavian (64 vs 69)] or jugular (36 vs 31%)], and type of catheters (single-lumen 18 vs 18%; double-lumen 82 vs 82%), and mean (median) duration of catheterisation [12.0+/-11.7 (9) vs 10.5+/-8.8 (8) days in the NCC and ACC groups, respectively]. Significant colonisation of the catheter occurred in 23 (13.1%) and 7 (3.7%) patients, respectively, in the NCC and ACC groups (11 vs 3.6 per 1000 catheter-days; p=0.01); CVC-related infection (bloodstream infection) occurred in 10 (5) and 4 (3) patients in the NCC and CC groups, respectively (5.2 vs 2 per 1000 catheter days; p=0.10).<bold>Conclusions: </bold>In the context of a low baseline infection rate, ACC were associated with a significant reduction of catheter colonisation and a trend to reduction of infection episodes, but not of bloodstream infection.
- Subjects
FRANCE; CRITICAL care medicine; ANTISEPTICS; ANTI-infective agents; DISINFECTION &; disinfectants; CATHETERS; INTERVENTIONAL radiology equipment; DRUG delivery devices; BACTEREMIA prevention; CHLORHEXIDINE; SILVER sulfadiazine; BACTERICIDES; BACTEREMIA; CLINICAL trials; COMPARATIVE studies; INTENSIVE care units; RESEARCH methodology; MEDICAL cooperation; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; BLIND experiment; SEVERITY of illness index; CENTRAL venous catheterization; MEDICAL equipment contamination; PREVENTION; THERAPEUTICS
- Publication
Intensive Care Medicine, 2004, Vol 30, Issue 5, p837
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-004-2221-9