The Role of Antimicrobial-Impregnated Catheters on Catheter-Related Bloodstream Infection Prevention

Abstract

Context: The catheterization of a central venous catheter (CVC) may be needed due to different motives. However, that central venous catheterization has different risks such as infection, which leads to morbidity, mortality and assistant costs. Different measures to prevent catheter-related infection have been proposed. Evidence Acquisition: Electronic medical data bases (including PubMed and Scopus) from first of January 1975 to 30th of July 2015 were searched. The key words used for the relevant articles search were catheter, venous, prevention, impregnated, bloodstream, chlorhexidine-silver sulfadiazine, rifampicin-minocycline, and rifampicin-miconazole. This review focuses on the evidence on the efficacy and efficiency of antimicrobial impregnated catheters for the prevention of catheter-related bloodstream infections (CRBSI). Results: The use of catheters impregnated in different antimicrobial agents has been found to be an effective and efficient measure for the prevention of CRBSI. Most antimicrobial agents used for such impregnation have been chlorhexidine silver sulfadiazine (CHSS), rifampicin-minocycline, and rifampicin-miconazole. The use of a CHSS or rifampicin-minocycline impregnated catheter in patients has been recommended by the current guidelines for the prevention of CRBSI when CVC is expected to remain in place for > 5 days and if the CRBSI rate has not decreased after implementation of a comprehensive strategy. Conclusions: Based on the current knowledge, it can be assumed that the use of antimicrobial impregnated catheters could be considered in some clinical circumstances associated with higher risk of CRBSI, such as patients with a CVC in the internal jugular venous site with the presence of tracheostomy or in the femoral venous site.