Differences in Efficacy between Antibacterial Lock Therapy and the Standard of Care for CVC-Related Infections: A Systematic Review and Meta-Analysis

• Published in: Clinics and practice 2024-08, Vol.14 (4), p.1538-1549
• Main Authors: Calabrese, Vincenzo, Farina, Alessandra, Maressa, Veronica, Cernaro, Valeria, Gembillo, Guido, Messina, Roberta Maria, Longhitano, Elisa, Ferio, Cinzia, Venanzi Rullo, Emanuele, Santoro, Domenico
• Format: Article
• Language: English
• Subjects: antibacterial lock therapy; Antibiotics; Anticoagulants; Antimicrobial agents; Bias; Catheters; CVC-related infections; Infections; Medical equipment; Meta-analysis; Observational studies; Pediatrics; Standard of care; Systematic Review
• ISSN: 2039-7283; 2039-7275; 2039-7283
• DOI: 10.3390/clinpract14040124

Background: Central Venous Catheter (CVC)-related infections cannot always be solved by replacement, due to some vascular anomalies or an emergency status. This comprehensive, evidence-based review aimed to define the efficacy of antibacterial lock therapy (ALT) compared to the standard of care (SoC) in CVC-related infections. Methods: We performed a systematic search in PubMed, Embase, and Google Scholar, looking for randomized controlled trials (RCTs) and cohort or case-control observational studies. The eligible studies considered the subjects with a diagnosis of CVC-related infections treated with antibacterial lock therapy (ALT) compared to the standard of care (SoC). Results: Among 609 records at the end of the selection process, five articles, referring to observational studies, were included in this systematic review. In pooled analyses, including a total of 276 individuals, microbiological healing (OR 3.78; 95% CI; 2.03–7.03) showed significant differences between ALT and the SoC, with a follow-up varying from 2 weeks to 3 months. Conclusions: Our results suggested that ALT could improve the preservation of CVCs and could be considered when their replacement is not possible as a result of vascular problems. However, only observational studies were included and RCTs are needed to confirm these findings and to increase the level of evidence.