Benefits of minocycline and rifampin-impregnated central venous catheters

• DOI: 10.1007/s00134-004-2378-2
• Publication Date: 2004-07-19T01:48:56Z
• Authors: Cristóbal León; Sergio Ruiz-Santana; Jordi Rello; Maria V. de la Torre; Jordi Vallés; Francisco Álvarez...; Rafael Sierra; Pedro Saavedra; Francisco Álvarez...
• Keywords: Colonization; Risk; Catheterization, Central Venous; Critical Illness; Blood-Stream Infection; Minocycline; Critically-Ill Patients; 03 medical and health sciences; Catheters, Indwelling; Drug Delivery Systems; 0302 clinical medicine; Double-Blind Method; Intensive-Care-Unit; 3201 Ciencias clínicas; Blood-Borne Pathogens; Humans; Prospective Studies; Cross Infection; Prevention; Chlorhexidine; Bacterial Infections; Anti-Bacterial Agents; 3. Good health; Intensive Care Units; Treatment Outcome; Adherence; Rifampin; 32 Ciencias médicas

To determine the efficacy of minocycline and rifampin-impregnated catheters compared to non-impregnated catheters in critically ill patients.Prospective, randomized, double-blind, controlled, multicenter trial.Intensive care units of seven acute-care teaching hospitals in Spain. PATIENTS. Intensive care unit patients requiring triple-lumen central venous catheter for more than 3 days.At catheter insertion, 228 patients were randomized to minocycline and rifampin-impregnated catheters and 237 to non-impregnated catheters. Skin, catheter tip, subcutaneous segment, hub cultures, peripheral blood and infusate cultures were performed at catheter withdrawal. The rate of colonization, catheter-related bloodstream infection (CRBSI) and catheter-related clinical infectious complications (purulence at the insertion site or CRBSI) were assessed.In the intention-to-treat analysis (primary analysis), the episodes per 1000 catheter days of clinical infectious complications decreased from 8.6 to 5.7 (RR =0.67, 95% CI 0.31-1.44), CRBSI from 5.9 to 3.1 (RR =0.53, 95% CI 0.2-1.44) and tip colonization from 24 to 10.4 (RR =0.43, 95% CI 0.26-0.73). Antimicrobial-impregnated catheters were associated with a significant decrease of coagulase-negative staphylococci colonization (RR =0.24, 95% CI 0.13-0.45) and a significant increase of Candida spp. colonization (RR =5.84, 95% CI 1.31-26.1).The use of antimicrobial-impregnated catheters was associated with a significantly lower rate of coagulase-negative staphylococci colonization and a significant increase in Candida spp. colonization, although a decrease in CRBSI, increase in 30-day survival or reduced length of stay was not observed.