The use of rifampicin-miconazole-impregnated catheters reduces the incidence of femoral and jugular catheter-related bacteremia

Clin Infect Dis. 2008 Nov 1;47(9):1171-5. doi: 10.1086/592253.

Abstract

Background: The guidelines of the Centers for Disease Control and Prevention do not recommend the use of an antimicrobial- or antiseptic-impregnated catheter for short-term use. In previous studies, we have found a higher incidence of central venous catheter-related bacteremia among patients with femoral and central jugular accesses than among patients with other venous accesses.

Objective: The objective of our study was to determine the incidence of central venous catheter-related bacteremia associated with rifampicin-miconazole-impregnated catheters and standard catheters in patients with femoral and central jugular venous accesses.

Methods: This was a cohort study, conducted in the 24-bed polyvalent medical-surgical intensive care unit of a university hospital. We included patients who were admitted to the intensive care unit from 1 June 2006 through 30 September 2007 and who underwent femoral or central jugular venous catheterization.

Results: We inserted 184 femoral (73 rifampicin-miconazole-impregnated catheters and 111 standard catheters) and 241 central jugular venous catheters (114 rifampicin-miconazole-impregnated catheters and 127 standard catheters). We found a lower rate of central venous catheter-related bacteremia associated with rifampicin-miconazole-impregnated catheters than with standard catheters among patients with femoral access (0 vs. 8.62 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.86; P = .03) and among patients with central internal jugular access (0 vs. 4.93 cases per 1000 catheter-days; odds ratio, 0.13; 95% confidence interval, 0.00-0.93; P = .04).

Conclusions: Rifampicin-minonazole-impregnated catheters are associated with a statistically significant reduction in the incidence of catheter-related bacteremia in patients with short-term catheter use at the central jugular and femoral sites.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Bacteremia / etiology
  • Bacteremia / prevention & control*
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / methods*
  • Catheters, Indwelling* / adverse effects
  • Coated Materials, Biocompatible
  • Cohort Studies
  • Female
  • Femoral Vein
  • Humans
  • Jugular Veins
  • Male
  • Miconazole / administration & dosage
  • Middle Aged
  • Rifampin / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Coated Materials, Biocompatible
  • Miconazole
  • Rifampin