Amuchina 10% Solution, Safe Antiseptic for Preventing Infections of Exit-Site of Tenckhoff Catheters, in the Pediatric Population of a Dialysis Program

Abstract

Although, decreasing in incidence with the disconnection systems, the first complication is still peritonitis in patients with chronic renal failure and the second is infection of Tenckhoff catheter exit-site. All efforts made to diminish the frequency of exit-site infection lower the possibility of peritonitis. The pediatric population is well-known to have a major risk of infectious complications, and making easy and safe the care of the exit-site will prevent the peritonitis that follows. The aim of the study was to evaluate the efficacy of the Amuchina 10% solution vs. pH neutral soap in children with chronic renal failure, on preventing exit-site infection. There were 60 patients who were assigned randomly to one of two groups. One group used Amuchina 10% solution for the daily cleaning of the exit-site, and the other used pH neutral soap, with 14 months of follow-up. Before the study they have to be free of infection for at least 30 days. All were taught by the same nurse how to clean their exit-site. Groups were almost identical in years, sex, and time on dialysis. We had nine infections in the soap group and none in the Amuchina 10% solution group, with an OR: 17 (p = 0.004). From these nine infections, the bacteria isolated were: 4 (13%) were caused by Pseudomona aeruginosa, 1 (3.3%) by Staphylococcus aureus, coagulase-positive staphylococci in 2 (6.6%) and Serratia marcensens in 1 (3.3%). In conclusion, Amuchina 10% solution is effective in preventing infection on the exit-site, without any secondary topical reaction.

ISPD Catheter-Related Infection Recommendations: 2017 Update

“…A randomized controlled trial showed that daily chlorhexidine care at the exit site is superior to normal saline cleansing for the prevention of exit site colonization by S. aureus (97). Four prospective studies showed that Amuchina solution (an electrolytic chloroxidizing solution containing sodium hypochlorite) at 3% to 10% is effective in preventing infection at the exit site, without any secondary topical reaction (98)(99)(100)(101). The addition of sodium hypochlorite solution to topical mupirocin may further reduce the rate of ESI and peritonitis in pediatric PD patients (102).…”

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

“…The ESI rates with Amuchina 10% (electrolytically produced sodium hypochlorite solution) and Amuchina 5% are similar to or lower than those seen with povidone iodine or chlorhexidine in adults. A recent RCT in children compared pH-neutral soap with Amuchina 10% solution and showed a favorable effect for Amuchina in preventing ESIs (67,68). Another recent retrospective study in 83 children demonstrated similar results, in that the combination of mupirocin and sodium hypochlorite for daily exit-site care was very effective and superior to mupirocin alone as a means of reducing PD catheter–associated infections and of prolonging catheter survival (69).…”

ISPD Catheter-related Infection Recommendations: 2023 Update

“…68 The outcomes from this study should be interpreted with caution due to the lack of concurrent comparison group and small sample size, warranting further studies to be conducted prior to broader implementation. Another cleansing agent, Amuchina solution, an electrolytic chloroxidizing solution containing sodium hypochlorite (3–10%), has been shown to be effective in preventing exit site infection in paediatric patients 69 without any secondary skin reaction. A retrospective observational study of 83 paediatric PD patients observed a significant reduction in catheter-related infection rates from 1.36 episodes per patient-year with application of mupirocin at exit site to 0.33 episodes per patient-year when mupirocin was augmented with sodium hypochlorite solution ( p < 0.0001) without occurrence of mupirocin-resistant organisms.…”