The efficacy of taurolidine containing lock solutions for the prevention of central-venous-catheter-related bloodstream infections: a systematic review and meta-analysis

Bosch, Ceder H. van den; Jeremiasse, Bernadette; Bruggen, Tjomme van der; Frakking, Florine N. J.; Loeffen, Yvette G.T.; Ven, Cornelis P. van de; Steeg, Alida F. W. van der; Fiocco, Marta; Wetering, Marianne D. van de; Wijnen, Marc H. W. A.

doi:10.1016/j.jhin.2021.10.022

Cited by 26 publications

(19 citation statements)

References 66 publications

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“…In their study, Bosch et al estimated a 0.30 pooled incidence rate ratio with a confidence interval of 0.19-0.46 for 918 patients in nine studies that favored taurolidine-containing lock solutions. They also reported mild and scarce adverse events [ 26 ]. In another study, Roden et al reported that removal of central venous catheters due to infection or catheter malfunction occurred less often in the presence of taurolidine-based lock solutions [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Antifungal activity of Taurolidine against Mucorales: an in-vitro study on clinical isolates

Jafarian

Amanati

Badiee

2022

CMM

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Background and Purpose: Taurolidine is active against a wide variety of microorganisms, including bacteria and fungi. Mucormycosis is one of the life-threatening opportunistic fungal infections, especially in immunocompromised patients. Currently, the emergence of Mucormycosis during the COVID-19 pandemic raises public health concerns regarding untoward morbidity and mortality among SARS-CoV-2 patients. It is well-known that delayed and inappropriate antifungal therapy leads to increased morbidity and mortality. This study aimed to investigate the in-vitro antifungal activity of taurolidine to evaluate its effects against clinical isolates of Mucorales. Materials and Methods: This study included previously collected clinical Mucorales isolates. The minimum in vitro inhibitory concentration (MIC) of amphotericin B, caspofungin, voriconazole, posaconazole, and itraconazole was determined using the broth microdilution method. Results: All clinical isolates showed full sensitivity to amphotericin B. Posaconazole MIC range from 8 μg/mL to 0.032 μg/mL. The MIC range of voriconazole and caspofungin were determined to be 2-8 µg/mL and 0.5-16 µg/mL, respectively. Growth of the isolates was entirely inhibited in 1000 µg/mL concentration of taurolidine. In microscopic observations, morphological effects on hyphal growth were observed at 500 µg/mL concentration. Conclusion: In conclusion, this is an updated experience of using taurolidine against Mucorales. However, our in-vitro findings need to be confirmed in well-designed clinical trials aimed at treating invasive Mucormycosis infections

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Section: Discussionmentioning

confidence: 99%

Antifungal activity of Taurolidine against Mucorales: an in-vitro study on clinical isolates

Jafarian

Amanati

Badiee

2022

CMM

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“…For paediatric oncology specifically, two RCTs have been performed which showed reductions of 74% and 77%. 6 For each patient that prematurely drops-out of the study an extra patient will be included, we estimated that an extra 50 patients would be needed to account for potential drop-outs. The drop-out inflated total sample size is therefore calculated as 462 patients, 231 per group.…”

Section: Methodsmentioning

confidence: 99%

“… 6 However, these studies were associated with a serious risk of bias and indirectness of evidence. 6 More specifically, in paediatric oncology patients, only two open-labelled RCTs) (N≤112) and four non-RCTs) have been performed. 12–17 To summarise, these studies did show promising results of the TCHL, but this was not enough evidence to implement the TCHL in paediatric oncology patients.…”

Section: Introductionmentioning

confidence: 99%

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CATERPILLAR-study protocol: an assessor-blinded randomised controlled trial comparing taurolidine-citrate-heparin to heparin-only lock solutions for the prevention of central line-associated bloodstream infections in paediatric oncology patients

et al. 2023

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IntroductionThe efficacy of taurolidine containing lock solutions for the prevention of central line-associated bloodstream infections (CLABSI) in paediatric oncology patients is still unknown. If the taurolidine-citrate-heparin lock appears to decrease the incidence of CLABSIs, we hope to increase the quality of life of children with cancer by subsequently reducing the central venous access device (CVAD)-removal rates, dispense of antibiotics, hospital admissions and incidence of severe sepsis resulting in intensive care unit admission.Methods and analysisThis assessor-blinded randomised controlled trial including 462 patients was designed to compare the taurolidine-citrate-heparin lock to the heparin-only lock for the prevention of CLABSIs in paediatric oncology patients. Patients receiving their first CVAD at the Princess Máxima Centre for Paediatric Oncology, Utrecht, the Netherlands, are eligible for inclusion. The primary outcome of this study is the incidence of first CLABSIs from CVAD insertion until the end of the study, maximum follow-up of 90 days. An intention-to-treat and a per-protocol analysis will be performed. An interim analysis will be performed after the inclusion of 50% of the patients. The results of the interim analysis and overall conduct of the trial will be discussed by a data safety monitoring board.Ethics and disseminationThe medical ethics committee NedMec, Utrecht, the Netherlands, has approved this research (number 20/370). Written informed consent for participation in this trial and publication of the trial data is obtained from all patients and/or their parents/guardians. The results of this trial will be published in a peer-reviewed journal and the data will be made available on reasonable request after publication of the main results manuscript.Trial registration numbersNTR6688;NCT05740150.

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“…If line salvage is pursued, infusion of targeted systemic antibiotics should occur through the contaminated line as part of the salvage strategy. Antibiotic lock therapy, ethanol lock therapy, and taurolidine lock therapy, when available, may be viable options for catheter salvage and/or prevention of future CRBSI 77–79 …”

Section: Cvc‐related Complicationsmentioning

confidence: 99%

Short bowel syndrome: Complications and management

Bering

DiBaise

2023

Nut in Clin Prac

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Short bowel syndrome (SBS) occurs when a patient loses bowel length or function significantly enough to cause malabsorption, oftentimes requiring lifelong parenteral support. In adults, this occurs most commonly in the setting of massive intestinal resection, whereas congenital anomalies and necrotizing enterocolitis predominate in children. Many patients with SBS develop long-term clinical complications over time related to their altered intestinal anatomy and physiology or to various treatment interventions such as parenteral nutrition and the central venous catheter through which it is administered. Identifying, preventing, and treating these complications can be challenging. This review will focus on the diagnosis, treatment, and prevention of several complications that can occur in this patient population, including diarrhea, fluid and electrolyte imbalance, vitamin and trace element derangements, metabolic bone disease, biliary disorders, small intestinal bacterial overgrowth, D-lactic acidosis, and complications of central venous catheters.

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The efficacy of taurolidine containing lock solutions for the prevention of central-venous-catheter-related bloodstream infections: a systematic review and meta-analysis

Cited by 26 publications

References 66 publications

Antifungal activity of Taurolidine against Mucorales: an in-vitro study on clinical isolates

Antifungal activity of Taurolidine against Mucorales: an in-vitro study on clinical isolates

CATERPILLAR-study protocol: an assessor-blinded randomised controlled trial comparing taurolidine-citrate-heparin to heparin-only lock solutions for the prevention of central line-associated bloodstream infections in paediatric oncology patients

Short bowel syndrome: Complications and management

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