Effect of vancomycin as antibiotic lock technique in prevention of catheter associated infection in stem cell transplantation patients

Abstract

Introduction: This trial assessed the efficacy of vancomycin lock solution in reducing catheter-related blood stream infections among bone marrow transplantation patients who were transplanted using tunneled catheters. Methods and Results: patients randomly received either heparin only (control group) or a mixture of 5 mg/ml vancomycin and 2500 U/ml heparin (antibiotic group) as catheter lock solution. Results: The control group, CRBSIs rates per1000 catheter-days was significantly lower (0.1609 vs 6.214 events; p=0.0265, Hazard ratio 4.924 %95 CI of ratio1.238-31.20) and BSI (Blood Stream Infection) rates per 1000 catheter-days was significantly lower (0.2744vs 3.644events; p=0.0073, Hazard ratio 7.209 %95 CI of ratio (0.03205-0.808)). More over, The cumulative infection-free catheter survival was significantly higher (log rank statistic 4.924 p=0.0265) in the antibiotic group and cumulative infection-free survival was significantly higher (log rank statistic 7.209 p=0.0073) in the antibiotic group compared with the control group. There is no significant difference in catheter removal incidence (27.27% in the antibiotic group vs 15.38% in the control group; p=0.245) between the two group. Conclusion: Vancomycin containing catheter lock solution is effective in reducing CRBSIs incidence and prolonging central vein catheter survival in Hematopoietic stem cell transplantation (HSCT) patients.