Factors affecting the patency and complications of peripheral intravenous catheters in newborns

Tseng, Ju-Huei; Chen, Ying-Fang Elaine; Chang, Sun-Peng; Wang, Hsiao-Chin; Kuo, Yung Ting

doi:10.1016/j.pedneo.2022.07.011

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…The current practice is to administer antibiotics intravenously for the entire period 4–6 8. However, intravenous therapy has disadvantages, including the need for hospitalisation and intravenous peripheral catheter reinsertions 9–11. There is emerging evidence to support the effectiveness and safety of switch from intravenous-to-oral administration of antibiotic therapy in neonates with EOI 12–18…”

Section: Introductionmentioning

confidence: 99%

Switch from intravenous-to-oral antibiotics in neonatal probable and proven early-onset infection: a prospective population-based real-life multicentre cohort study

Carlsen

Dungu

Lewis

et al. 2023

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo evaluate the implementation of switch from intravenous-to-oral antibiotic therapy with amoxicillin in neonates with early-onset infection (EOI).Design, setting and patientsA population-based multicentre cohort study. All term-born neonates with EOI were prospectively included between 1 December 2018 to 30 November 2020.InterventionIntravenous-to-oral switch antibiotic therapy in clinically stable neonates.Main outcome measuresThe primary outcome was readmission due to infection. Secondary outcomes were days of hospitalisation and antibiotic use in the pre-implementation versus post implementation period.ResultsDuring 2 years, 835 neonates commenced antibiotics for EOI (1.5% (95% CI 1.4% to 1.6%)) of all term live births). Of those, 554 (66%) underwent a full course of treatment. There were 23 episodes of culture-proven infection (0.42 per 1000 term live births (95% CI 0.27 to 0.63)). A total of 478 of 531 (90%) neonates with probable infection underwent switch therapy. None was readmitted due to infection. The median duration of hospitalisation was 3.0 days (IQR 2.5–3.5) and 7.4 days (IQR 7.0–7.5) in the switch and intravenous therapy groups, respectively. According to antibiotic surveillance data, 1.2% underwent a full course of treatment following implementation of oral switch therapy (2019–2020), compared with 1.2% before (2017–2018).ConclusionIn clinical practice, switch therapy was safe and used in 9 of 10 neonates with probable EOI. Knowledge of the safety of antibiotic de-escalation is important as home-based oral therapy ameliorates the treatment burden for neonates, caregivers and healthcare systems. Despite the ease of oral administration, implementation of switch therapy did not increase the overall use of antibiotics.

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Section: Introductionmentioning

confidence: 99%

Switch from intravenous-to-oral antibiotics in neonatal probable and proven early-onset infection: a prospective population-based real-life multicentre cohort study

Carlsen

Dungu

Lewis

et al. 2023

Arch Dis Child Fetal Neonatal Ed

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Reducing complications and extending the lifespan of peripheral intravenous catheters in newborns–simple and feasible methods

Lee¹

2023

Pediatrics & Neonatology

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Effectiveness and Safety of Measures to Prevent Infections and Other Complications Associated With Peripheral Intravenous Catheters: A Systematic Review and Meta-analysis

Dobrescu,

Constantin,

Pinte

et al. 2024

Clinical Infectious Diseases

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Background Peripheral intravenous catheters (PIVCs) contribute substantially to the global burden of infections. This systematic review assessed 24 infection prevention and control (IPC) interventions to prevent PIVC-associated infections and other complications. Methods We searched Ovid MEDLINE, Embase, Cochrane Library, WHO Global Index Medicus, CINAHL and reference lists for controlled studies, from January 1, 1980–March 16, 2023. We dually selected studies, assessed risk of bias, extracted data, and rated the certainty of evidence (COE). For outcomes with three or more trials, we conducted Bayesian random-effects meta-analyses. Results 105 studies met our prespecified eligibility criteria, addressing 16 of the 24 research questions; no studies were identified for eight research questions. Based on findings of low to high COE, wearing gloves reduced the risk for overall adverse events related to insertion compared to no gloves (one non-randomised controlled trial [RCT]; adjusted risk ratio [RR]: 0.52, 95% confidence interval 0.33–0.85), and catheter removal based on defined schedules potentially resulted in a lower phlebitis/thrombophlebitis incidence (10 RCTs; RR: 0.74, 95% credible interval 0.49–1.01) compared to clinically indicated removal in adults. In neonates, chlorhexidine reduced the phlebitis score compared to non-chlorhexidine-containing disinfection (one RCT; 0.14 versus 0.68, p = 0.003). No statistically significant differences were found for other measures. Conclusions Despite their frequent use and concern about PIVC-associated complications, this review underscores the urgent need for more high-quality studies on effective IPC methods regarding safe PIVC management. In the absence of valid evidence, adherence to standard precaution measures and documentation remain the most important principles to curb PIVC complications.

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Factors affecting the patency and complications of peripheral intravenous catheters in newborns

Cited by 3 publications

References 18 publications

Switch from intravenous-to-oral antibiotics in neonatal probable and proven early-onset infection: a prospective population-based real-life multicentre cohort study

Switch from intravenous-to-oral antibiotics in neonatal probable and proven early-onset infection: a prospective population-based real-life multicentre cohort study

Reducing complications and extending the lifespan of peripheral intravenous catheters in newborns–simple and feasible methods

Effectiveness and Safety of Measures to Prevent Infections and Other Complications Associated With Peripheral Intravenous Catheters: A Systematic Review and Meta-analysis

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