Prevention of hemodialysis catheter-related blood stream infections using a cotrimoxazole-lock technique

Future Microbiol. 2015;10(2):169-78. doi: 10.2217/fmb.14.116.


Background & aim: This trial assessed the efficacy of cotrimoxazole lock solution in reducing catheter-related blood stream infections (CRBSIs) among hemodialysis (HD) patients who were dialyzed using tunneled catheters.

Method: Patients randomly received either heparin (2500 U/ml) (control group) or a mixture of 10 mg/ml cotrimoxazole (based on trimethoprim) and 2500 U/ml heparin (antibiotic group) as catheters lock solution.

Results: Compared with the control group, CRBSIs rates per 1000 catheter-days was significantly lower (0.58 vs 4.4 events; p = 0.002) and cumulative infection-free catheter survival was significantly higher (log rank statistic 5.88; p = 0.015) in the antibiotic group. There were no statistical differences regarding incidences of catheter removal (8.7% in the antibiotic group vs 22% in the control group; p = 0.116) or thrombosis (2.2% in the antibiotic group vs 9.8% in the control group; p = 0.129) between the two groups.

Conclusion: cotrimoxazole containing catheter lock solution is effective in reducing CRBSIs incidence and prolonging dialysis catheter survival in HD patients.

Keywords: antibiotic lock solution; catheter-related bacteremia; cotrimoxazole; tunneled hemodialysis catheter.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis*
  • Bacteremia / prevention & control*
  • Blood / microbiology
  • Catheter-Related Infections / prevention & control*
  • Female
  • Heparin / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage*
  • Vascular Access Devices / microbiology*


  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Heparin