Vancomycin flush solution for prevention of catheter-related infections in oncology patients with PICC: a systematic review of the effectiveness

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Objective To assess the efficacy of vancomycin flush solution for prevention of catheter-related infections in oncology patients. Methods Randomized controlled trials(RCTs) were searched and identified from Cochrane library, PubMed, EMBASE, CBM, CNKI and related journals were also scanned. In accordance with inclusion and exclusion criteria, we evaluated the quality of the included studies by Jadad scale and analyzed the data of catheter- related sepsis, catheter colonization, exit- site infection by RevMan 5.0. Results We included 5 randomized controlled trials (400 patients). Meta analysis showed that there were statistical differences between vancomycin- heparin mixture and heparin solution on the incidence of catheter-related sepsis, catheter colonization, but no difference was found on the incidence of exit-site infection. Conclusions The current evidences show that contrast with heparin flush solution, van comycin - heparin flush solution can significantly reduce the incidence, of catheter - related sepsis and catheter colonization. But vancomycin-heparin flush solution was more effective, and the results should be further confirmed in prevention of Gram-positive bacterial and fungal catheter-related infections or in non- neutropenic patients. Before draw the conclusions, further high-quality, large scale, double-blind randomized controlled trials are still needed. Key words: Vancomycin; Prophylaxis; CVCs; Infection; Systematic review