A Randomized, Controlled Trial of the Efficacy of a Heparin and Vancomycin Solution in Preventing Central Venous Catheter Infections in Children

J Pediatr. 1995 Jul;127(1):147-51. doi: 10.1016/s0022-3476(95)70276-8.

Abstract

Objective: To determine whether adding vancomycin to central venous catheter (CVC) flush solution would significantly reduce the incidence of bacteremia attributable to luminal colonization with vancomycin-susceptible organisms.

Study design: Fifty-five children with cancer and eight children given total parenteral nutrition by the surgery or nutrition support services were randomly assigned to receive a heparin CVC flush solution (n = 31) or a heparin-vancomycin CVC flush solution (n = 32).

Results: During 9158 catheter days, 6.5% of the patients in the heparin group and 15.6% of the patients in the heparin-vancomycin group had bacteremia attributable to luminal colonization with vancomycin-susceptible organisms (p = 0.43). The mean rates of bacteremia attributable to luminal colonization with vancomycin-susceptible organisms were 0.6/1000 catheter days in the heparin group and 1.4/1000 catheter days in the heparin-vancomycin group (p = 0.25). There was no significant difference between the groups when the time to the first episode of bacteremia attributable to luminal colonization with a vancomycin-susceptible organism was compared by means of Kaplan-Meier survival estimates. Streptococcus viridans infection was not attributable to luminal colonization.

Conclusion: The addition of vancomycin to heparin CVC flush solution did not reduce bacteremia with vancomycin-susceptible organisms. Bacteremia with Streptococcus viridans was not related to the use of a CVC.

Publication types

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

MeSH terms

  • Adolescent
  • Bacteremia / drug therapy*
  • Bacteremia / etiology
  • Bacteremia / microbiology
  • Catheterization*
  • Child
  • Child, Preschool
  • Drug Combinations
  • Enterococcus / isolation & purification
  • Enterococcus / pathogenicity
  • Heparin / administration & dosage
  • Heparin / therapeutic use*
  • Humans
  • Parenteral Nutrition*
  • Solutions*
  • Streptococcus / isolation & purification
  • Streptococcus / pathogenicity
  • Treatment Outcome
  • Vancomycin / administration & dosage
  • Vancomycin / therapeutic use*

Substances

  • Drug Combinations
  • Solutions
  • Vancomycin
  • Heparin