A comparison of two methods of treatment for catheter-related bloodstream infections in patients on home parenteral nutrition

Prevention of Subsequent Catheter‐Related Bloodstream Infection Using Catheter Locks in High‐Risk Patients Receiving Home Parenteral Nutrition

“…The authors concluded that the use of ALT‐ELT combination was equally effective as catheter replacement in the management of CRBSI. Although it seems that these 2 strategies are equivalent, it is our opinion that the locking strategies are more economical and in some aspects superior to catheter removal, especially in long‐term patients in whom repeated catheter removals can result in lack of access 11 …”

“…In a more recent study, authors compared 2 approaches for the management of CRBSI in HPN patients: the use of ALT‐ELT combination vs catheter replacement 11 . A total of 428 patients from January 1, 2005, to December 31, 2010, were included in the analyses 11 . The authors reported that a total of 181 patients had a total of 352 CRBSI episodes during the study period when managed with 1 of the 2 approaches.…”

“…The authors reported that a total of 181 patients had a total of 352 CRBSI episodes during the study period when managed with 1 of the 2 approaches. The mean time to recurrence of infection with the same microbial species from completion of ALT‐ELT combination or catheter replacement was 265 days after ALT‐ELT combination and 330 days after catheter replacement ( P = .051) 11 . Furthermore, they reported that there was no significant difference between the 2 approaches in terms of likelihood of survival or duration of catheter use after an episode of CRBSI caused by various bacterial species.…”

“…Data regarding the prophylactic use of ALT and ELT in patients receiving HPN are limited. One retrospective study compared the outcomes of management of CRBSI with a combination of ALT‐ELT therapy vs catheter removal 11 . They reported that the use of ALT‐ELT for the management of CRBSI was equally effective as catheter replacement.…”

Parenteral Nutrition in Interventional Radiology: Consideration and Management of the Patient

“…23,24 Antibiotic locking solutions are often created with an anticoagulant and may include cefazolin, cefotaxime, ceftazidime, daptomycin, linezolid, telavancin, ticarcillin/clavulanic acid, vancomycin, amikacin, teicoplanin, gentamicin, ciprofloxacin, cefepime, or caspofungin. [25][26][27] These solutions are customized to the sensitivity of the organism that is cultured from the infected catheter, 27 are used to prevent recurrence of central venous catheter infection, and are used in conjunction with systemic antibiotics to clear chronic colonization for catheter salvage. 26 In one study, more than 66% catheter salvage was possible in 33 of 70 patients treated for CLBSI when systemic antibiotic therapy and local antibiotic locking therapy were used for 14 to 28 days.…”