Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial

Exit-site and tunnel infections of tunnelled central intravascular catheters are a frequent source of morbidity among neutropenic patients and may necessitate catheter removal. They require antimicrobial therapy that increases healthcare costs and is associated with adverse drug reactions. A prospec...

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Bibliographic Details
Published in:The Journal of hospital infection 2005-09, Vol.61 (1), p.53-61
Main Authors: Chambers, S.T., Sanders, J., Patton, W.N., Ganly, P., Birch, M., Crump, J.A., Spearing, R.L.
Format: Article
Language:English
Subjects:
Administration, Topical
Adult
Anti-Infective Agents, Local - administration & dosage
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antineoplastic Agents - adverse effects
Antiseptics
Bandages
Biological and medical sciences
Bone Marrow Transplantation - adverse effects
Catheters, Indwelling - adverse effects
Chemotherapy
Chlorhexidine
Chlorhexidine - administration & dosage
Delayed-Action Preparations
Exit-site infection
Hematologic and hematopoietic diseases
Humans
Medical sciences
Neutropenia
Neutropenia - etiology
Other diseases. Hematologic involvement in other diseases
Pharmacology. Drug treatments
Prospective Studies
Surgical Wound Infection - etiology
Surgical Wound Infection - prevention & control
Treatment Outcome
Tunnelled intravascular catheter
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Summary:Exit-site and tunnel infections of tunnelled central intravascular catheters are a frequent source of morbidity among neutropenic patients and may necessitate catheter removal. They require antimicrobial therapy that increases healthcare costs and is associated with adverse drug reactions. A prospective randomized clinical trial was conducted among adult patients undergoing chemotherapy in a haematology unit. Tunnelled intravascular catheters were randomized to receive the control of a standard dressing regimen as recommended by the British Committee for Standards in Haematology, or to receive the intervention of a sustained-release chlorhexidine dressing. Follow-up data were available in 112 of 114 tunnelled intravascular catheters which were randomized. Exit-site or combined exit-site/tunnel infections occurred in 23 (43%) of 54 catheters in the control group, and five (9%) of 58 catheters in the intervention group [odds ratio (OR) for intervention group compared with control group =0.13, 95% confidence intervals (CI) 0.04–0.37, P
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2005.01.023