Any use for alternative lock solutions in the prevention of catheter-related blood stream infections?

J Vasc Access. 2017 Mar 6;18(Suppl. 1):34-38. doi: 10.5301/jva.5000681. Epub 2017 Mar 5.


The prevention of catheter-related blood stream infections (CRBSI) in hemodialysis (HD) patients remains a challenge because of high morbidity and mortality associated to CRBSI. Alternative locking solutions (ALS) containing an antithrombotic substance with additional antimicrobial or antibiofilm properties (citrate, ethylenediaminetetraacetic acid [EDTA], 70% ethanol, thrombolytics) with or without the addition of molecules with specific antimicrobial activity (antibiotics, taurolidine, paraben-methylene-blue) has been proposed with the aim to prevent or eradicate intraluminal biofilm colonization and subsequent CRBSI. In this review, we examine the available evidence concerning their efficacy and potential side effects, in order to determine whether ALS should be implemented widely or only in selected cases.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / therapeutic use*
  • Anticoagulants / therapeutic use
  • Bacteremia / diagnosis
  • Bacteremia / microbiology
  • Bacteremia / prevention & control*
  • Biofilms
  • Catheter-Related Infections / diagnosis
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control*
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation*
  • Catheters, Indwelling* / adverse effects
  • Catheters, Indwelling* / microbiology
  • Central Venous Catheters* / adverse effects
  • Central Venous Catheters* / microbiology
  • Equipment Design
  • Humans
  • Renal Dialysis*
  • Risk Factors
  • Treatment Outcome


  • Anti-Infective Agents
  • Anticoagulants