Are Antiseptic-Coated Central Venous Catheters Effective in a Real-World Setting?

Am J Infect Control. 2006 Aug;34(6):388-93. doi: 10.1016/j.ajic.2005.08.004.

Abstract

Background: Catheter-related bloodstream infections are common, costly, and morbid. Randomized controlled trials indicate that antiseptic-coated central venous catheters reduce infection rates.

Objective: To assess the clinical and economic effectiveness of antiseptic-coated catheters for critically ill patients in a real-world setting.

Methods: Central venous catheters coated with chlorhexidine/silver-sulfadiazene were introduced in all patients requiring central venous access in adult intensive care units at the University of Michigan Health System, a large, tertiary care teaching hospital. A pretest-posttest cohort design measured the primary outcome of catheter-related bloodstream infection rate, comparing the 2 years prior to the intervention with the 2 years following the intervention. We also evaluated cost-effectiveness and changes in vancomycin use.

Results: The intervention was associated with a 4% per month relative reduction in the incidence of catheter-related bloodstream infection, after controlling for the effects of time. Overall, a 35% relative risk reduction (P < .0003) in the catheter-related bloodstream infection rate occurred in the posttest phase. The use of antiseptic-coated catheters reduced costs more than $100,000 annually. Vancomycin use was less in units in which antiseptic catheters were used compared with wards in which these catheters were not used.

Conclusion: Antiseptic-coated catheters appear to be clinically effective and economically efficient in a real-world setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Infective Agents, Local / economics
  • Anti-Infective Agents, Local / pharmacology
  • Antisepsis / instrumentation
  • Antisepsis / methods*
  • Catheterization, Central Venous* / economics
  • Catheterization, Central Venous* / instrumentation
  • Catheters, Indwelling* / adverse effects
  • Catheters, Indwelling* / microbiology
  • Chlorhexidine / pharmacology
  • Cross Infection / economics
  • Cross Infection / prevention & control*
  • Hospitals, University
  • Humans
  • Poisson Distribution
  • Regression Analysis
  • Sepsis / economics
  • Sepsis / prevention & control*
  • Silver Sulfadiazine / pharmacology
  • Treatment Outcome
  • Vancomycin / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Vancomycin
  • Chlorhexidine
  • Silver Sulfadiazine