Chlorhexidine-silver sulfadiazine-impregnated venous catheters save costs

Abstract

Previous cost-effectiveness analyses have found that the use of chlorhexidine-silver sulfadiazine (CHSS)-impregnated catheters is associated with decreased catheter-related bloodstream infections (CRBSI) and central venous catheter (CVC)-related costs. However, in these analyses, the CVC-related cost included the increase of hospital stay. Our aim was to determine the immediate CVC-related cost (including only the cost of CVC, diagnosis of CRBSI, and antimicrobials for the treatment of CRBSI) of using a CHSS or a standard catheter in internal jugular venous access. We performed a prospective, observational, cohort study of patients admitted to the intensive care unit (ICU), Hospital Universitario de Canarias (Tenerife, Spain), who received 1 or more internal jugular venous catheters. The study included 245 CHSS-impregnated catheters and 391 standard catheters. Exact logistic regression analysis showed that CHSS-impregnated catheters were associated with a lower incidence of CRBSI, controlling for catheter duration, than standard catheters (0 vs 5.04 CRBSI per 1,000 catheter-days, respectively; odds ratio, 0.80; 95% confidence interval: 0.712-0.898; P < .001). Poisson regression showed that CHSS-impregnated catheters were associated with lower CVC-related cost per day than standard catheters (€3.78 ± €4.45 vs €7.28 ± €16.71, respectively; odds ratio, 0.52; 95% confidence interval: 0.504-0.535; P < .001). Survival analysis showed that CHSS-impregnated catheters were associated with increased CRBSI-free time compared with standard catheters (χ(2) = 14.9; P < .001). The use of CHSS-impregnated catheters reduced the incidence of CRBSI and immediate CVC-related costs in the internal jugular venous access.