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

Abstract

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.