A prospective randomized double-blind trial of bolus urokinase in the treatment of established Hickman catheter sepsis in children

Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America

“…Management of CRBSI should be distinguished on the basis of the removal or retention of the catheter, and a distinction should be made between complicated CRBSI, in which there is suppurative thrombophlebitis, endocarditis, osteomyelitis, or possible metastatic seeding, and uncomplicated CRBSI (figures 1–4). Intravenous administration of thrombolytic agents, such as urokinase, should not be used as adjunctive treatment for CRBSI [58, 59]. …”

Centrally Inserted External Catheters and Totally Implantable Ports for the Delivery of Chemotherapy: A Systematic Review and Meta-Analysis of Device-Related Complications

“…Overall, the follow-up periods of the RCTs ranged from 13 to 30 months. In terms of observational studies, 11 prospective (including the Dillon et al RCT) [5,[12][13][14][15][16][17][18][19][20][21] and 15 retrospective studies [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] evaluated the use of venous catheters in different patient populations. 11 studies were in the adult population [14,[23][24][25][26][28][29][30][31][32][33][34], of which 4 recruited only gynaecological patients [25,26,30,34], 13 were performed in children (age B21 years) [7, 12, 13, 15-22, 35, 36], and 1 was performed in a mixed population (age 3-78 years); for the purpose of analysis, this study population was defined as adult [27].…”

Prophylaxis With Urokinase in Pediatric Oncology Patients With Central Venous Catheters

“…A relationship between CVC thrombosis and bacteremia seems possible [10,24]. Urokinase, a thrombolytic agent commonly used in children, has also been used in an effort to eradicate CVC-related bacteremias with con¯icting results [25,26]. The observation that urokinase cannot completely dissolve intraluminal thrombi [27] could explain these results and we evaluated the effect of urokinase given regularly in an effort to prevent intraluminal thrombus formation.…”