Reducing catheter related bloodstream infection risk of infant with a prophylactic antibiotic therapy before removing peripherally inserted central catheter: A retrospective study

J Microbiol Immunol Infect. 2022 Dec;55(6 Pt 2):1318-1325. doi: 10.1016/j.jmii.2021.09.016. Epub 2021 Oct 9.


Purpose: This study examined the efficacy of prescribing antibiotics, specifically a single dose of vancomycin, in reducing the incidence of culture-positive and culture-negative sepsis prior to the removal of peripherally inserted central catheters (PICCs).

Materials and methods: We retrospectively reviewed charts of infants who had PICCs in a tertiary level hospital during the period from 2010 to 2019. The incidence of post-catheter removal clinical sepsis between the groups with or without antibiotics was compared. The antibiotic group was defined by receiving a single dose of vancomycin or any other antibiotic prior to line removal.

Results: We enrolled 585 PICC removal episodes in 546 infants for analysis. Antibiotics were given prior to removal in 257 cases (43.9%) and not given prior to removal in 328 cases (56.1%). There were 13 episodes of post-catheter removal clinical sepsis detected within 72 h (2.2%), 2 of which were culture-positive (0.3%). A 9.3-fold decrease in the odds for clinical sepsis was observed in the antibiotic group (p = 0.01). The incidence of post-catheter removal sepsis was decreased by a single prophylactic dose of vancomycin (p = 0.02), whereas the use of other antibiotics showed no effect (p = 0.35). Logistic regression analysis demonstrated that comorbidities with gastrointestinal diseases (p = 0.01), PICC insertion sites in the scalp and neck (p = 0.04), and no vancomycin administration prior to line removal (p = 0.02) were independent risk factors for subsequent clinical sepsis.

Conclusion: A single prophylactic dose of vancomycin prior to PICC line removal might reduce clinical sepsis events in infants.

Keywords: Antibiotics; Blood stream infection; Infants; Peripherally inserted central catheter.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Catheter-Related Infections* / drug therapy
  • Catheter-Related Infections* / epidemiology
  • Catheter-Related Infections* / prevention & control
  • Catheterization, Central Venous* / adverse effects
  • Catheters
  • Central Venous Catheters* / adverse effects
  • Humans
  • Infant
  • Retrospective Studies
  • Risk Factors
  • Sepsis* / drug therapy
  • Sepsis* / epidemiology
  • Sepsis* / prevention & control
  • Vancomycin / therapeutic use


  • Anti-Bacterial Agents
  • Vancomycin