Efficiency of chlorhexidine–silver sulfadiazine-impregnated venous catheters at subclavian sites

Abstract

Cost-effectiveness analyses show that chlorhexidine-silver sulfadiazine (CHSS)-impregnated catheters reduce catheter-related bloodstream infection (CRBSI) and central venous catheter (CVC)-related costs. However, no studies have reported the efficiency of CHSS-impregnated catheters for venous access when the risk of CRBSI is low; for example, at the subclavian site. This study determined the cost of a CVC, diagnosis of CRBSI, and antimicrobial agents to treat CRBSI; we did not consider the cost of increased hospital stay. This retrospective study included patients admitted to the intensive care unit at Hospital Universitario de Canarias (Tenerife, Spain) who had a subclavian venous catheter. Patients with CHSS catheters (n=353) had a lower incidence density of CRBSI (2.12 vs 0 out of 1,000 catheter-days; P=.02) and lower CVC-related cost per catheter-day (3.35±3.75 vs 3.94±9.95; P=.002) than those with standard catheters (n=518). CHSS-impregnated catheters were associated with a lower risk of CRBSI (exact logistic regression) (odds ratio,0.10; 95% confidence interval,-∞ to 0.667; P=.008) than standard catheters when controlling for catheter duration. CHSS-impregnated catheters were also associated with a lower CVC-related cost per catheter day than standard catheters (Poisson regression) (odds ratio,0.85; 95% confidence interval,0.001-0.873; P<.001). CHSS-impregnated catheters may be efficient in preventing CRBSI in patients with subclavian venous access.