Ethanol lock solution as an adjunct treatment for preventing recurrent catheter-related sepsis--first case report in dialysis setting

Ackoundou-N’Guessan, Clément; Heng, Anne-Élisabeth; Guenu, S.; Charbonné, F; Traoré, Ousmane; Deteix, P; Souweine, Bertrand

doi:10.1093/ndt/gfl358

Cited by 23 publications

(14 citation statements)

References 8 publications

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“…H 2 O 2 has been used for disinfection of oral hygiene devices and contact lenses (6,28,40). Also, the utility of ethanol (25 to 70%) as central venous catheter lock therapy is under investigation (1,31,35). The current study suggests that azole drugs, such as fluconazole, may act to enhance the activities of these biocides when they are used to prevent or treat fungal biofilms.…”

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confidence: 90%

Reduced Biocide Susceptibility in Candida albicans Biofilms

Nett

Guite²,

Ringeisen

et al. 2008

Antimicrob Agents Chemother

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Candida biofilm formation is common during infection and environmental growth. We tested the impacts of three biocides (ethanol [EtOH], H 2 O 2 , and sodium dodecyl sulfate) on Candida albicans, C. parapsilosis, and C. glabrata biofilms. Higher concentrations of the biocides were required for efficacy against biofilms than for efficacy against planktonic controls. A combination study with two biocides (EtOH and H 2 O 2 ) and fluconazole demonstrated that the combination had enhanced efficacy.

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mentioning

confidence: 90%

Reduced Biocide Susceptibility in Candida albicans Biofilms

Nett

Guite²,

Ringeisen

et al. 2008

Antimicrob Agents Chemother

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“…Anecdotal and case series publications point to the potential efficacy of ethanol as a lock therapy in prevention and treatment of central venous catheter infection [33-35]. If effective, it will provide a cost-effective intervention which could substantially reduce patient morbidity and mortality, in addition to health-care associated costs.…”

Section: Discussionmentioning

confidence: 99%

Rationale and design of the HEALTHY-CATH trial: A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients

et al. 2009

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BackgroundCatheter-related bacteraemias (CRBs) contribute significantly to morbidity, mortality and health care costs in dialysis populations. Despite international guidelines recommending avoidance of catheters for haemodialysis access, hospital admissions for CRBs have doubled in the last decade. The primary aim of the study is to determine whether weekly instillation of 70% ethanol prevents CRBs compared with standard heparin saline.Methods/designThe study will follow a prospective, open-label, randomized controlled design. Inclusion criteria are adult patients with incident or prevalent tunneled intravenous dialysis catheters on three times weekly haemodialysis, with no current evidence of catheter infection and no personal, cultural or religious objection to ethanol use, who are on adequate contraception and are able to give informed consent. Patients will be randomized 1:1 to receive 3 mL of intravenous-grade 70% ethanol into each lumen of the catheter once a week and standard heparin locks for other dialysis days, or to receive heparin locks only. The primary outcome measure will be time to the first episode of CRB, which will be defined using standard objective criteria. Secondary outcomes will include adverse reactions, incidence of CRB caused by different pathogens, time to infection-related catheter removal, time to exit site infections and costs. Prospective power calculations indicate that the study will have 80% statistical power to detect a clinically significant increase in median infection-free survival from 200 days to 400 days if 56 patients are recruited into each arm.DiscussionThis investigator-initiated study has been designed to provide evidence to help nephrologists reduce the incidence of CRBs in haemodialysis patients with tunnelled intravenous catheters.Trial RegistrationAustralian New Zealand Clinical Trials Registry Number: ACTRN12609000493246

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“…El problema es que existe una gran heterogeneidad en cuanto al diseño del estudio, el procedimiento de sellado, la concentración del etanol, el tiempo de sellado, el tiempo de intervención, las variables de resultado y el seguimiento, entre otros aspectos (Tabla VI) (30,31,45,(81)(82)(83)(84)(85)(86). También el tipo de pacientes incluidos eran muy diferentes.…”

Section: Sellados Con Etanolunclassified

Sellado con antibióticos o antisépticos en pacientes pediátricos con nutrición parenteral domiciliaria. Puesta al dí

et al. 2016

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Introduction: Home parenteral nutrition has become the mainstay for the support of patients with severe chronic intestinal failure. Despite the signifi cant advances that have occurred in recent decades in terms of vascular access and parenteral solutions, catheter-related bloodstream infections remain one of the most important complications. Antiseptic lock therapies, as ethanol or taurolidine; and antibiotic lock therapies are used in order to prevent or treat these infections. Objective: The aim of this article is to review the available scientifi c evidence regarding the use of antiseptic and antibiotic lock therapies in the management of pediatric patients with home parenteral nutrition. Material and methods: The use of ethanol or taurolidine lock therapy would be suggested in order to prevent catheter-related bloodstream infections in patients with home parenteral nutrition who have suffered from more than one infection in the previous year or in at-risk patients. Antibiotic locks are used for the treatment of catheter-related bloodstream infections due to S. coagulase negative and gram-negative bacilli in conjunction with systemic antimicrobial therapy, for whom catheter salvage is the goal. Catheter removal is recommended when there are signs of exit site or tunnel infection or the infection is due to S. aureus or Candida species. Conclusion: Despite the fact that evidence based data on the topic is scarce, there are a growing number of publications that support the use of antibiotics or antiseptic locks for the prevention or treatment of catheter-related infections in home parenteral nutrition patients, in whom catheter maintenance is a cornerstone for survival.

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Ethanol lock solution as an adjunct treatment for preventing recurrent catheter-related sepsis--first case report in dialysis setting

Cited by 23 publications

References 8 publications

Reduced Biocide Susceptibility in Candida albicans Biofilms

Reduced Biocide Susceptibility in Candida albicans Biofilms

Rationale and design of the HEALTHY-CATH trial: A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients

Sellado con antibióticos o antisépticos en pacientes pediátricos con nutrición parenteral domiciliaria. Puesta al dí

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