Comparison of antimicrobial impregnation with tunneling of long-term central venous catheters: a randomized controlled trial

Ann Surg. 2005 Aug;242(2):193-200. doi: 10.1097/01.sla.0000171874.29934.61.


Objective: We sought to compare the impact of antimicrobial impregnation to that of tunneling of long-term central venous catheters on the rates of catheter colonization and catheter-related bloodstream infection.

Summary background data: Tunneling of catheters constitutes a standard of care for preventing infections associated with long-term vascular access. Although antimicrobial coating of short-term central venous catheters has been demonstrated to protect against catheter-related bloodstream infection, the applicability of this preventive approach to long-term vascular access has not been established.

Methods: A prospective, randomized clinical trial in 7 university-affiliated hospitals of adult patients who required a vascular access for > or = 2 weeks. Patients were randomized to receive a silicone central venous catheter that was either impregnated with minocycline and rifampin or tunneled. The occurrence of catheter colonization and catheter-related bloodstream infection was determined.

Results: Of a total of 351 inserted catheters, 346 (186 antimicrobial-impregnated and 160 tunneled) were analyzed for catheter-related bloodstream infection. Clinical characteristics were comparable in the 2 study groups, but the antimicrobial-impregnated catheters remained in place for a shorter period of time (mean, 30.2 versus 43.8 days). Antimicrobial-impregnated catheters were as likely to be colonized as tunneled catheters (7.9 versus 6.3 per 1000 catheter-days). Bloodstream infection was 4 times less likely to originate from antimicrobial-impregnated than from tunneled catheters (0.36 versus 1.43 per 1000 catheter-days).

Conclusions: Antimicrobial impregnation of long-term central venous catheters may help obviate the need for tunneling of catheters.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minocycline / administration & dosage
  • Prospective Studies
  • Rifampin / administration & dosage
  • Sepsis / prevention & control*
  • Silicones


  • Anti-Bacterial Agents
  • Silicones
  • Minocycline
  • Rifampin