Intensive Care Medicine

, Volume 30, Issue 10, pp 1891–1899

Benefits of minocycline and rifampin-impregnated central venous catheters

A prospective, randomized, double-blind, controlled, multicenter trial
  • Cristóbal León
  • Sergio Ruiz-Santana
  • Jordi Rello
  • Maria V. de la Torre
  • Jordi Vallés
  • Francisco Álvarez-Lerma
  • Rafael Sierra
  • Pedro Saavedra
  • Francisco Álvarez-Salgado
  • for the Cabaña Study Group
Original

DOI: 10.1007/s00134-004-2378-2

Cite this article as:
León, C., Ruiz-Santana, S., Rello, J. et al. Intensive Care Med (2004) 30: 1891. doi:10.1007/s00134-004-2378-2

Abstract

Objective

To determine the efficacy of minocycline and rifampin-impregnated catheters compared to non-impregnated catheters in critically ill patients.

Design

Prospective, randomized, double-blind, controlled, multicenter trial.

Setting

Intensive care units of seven acute-care teaching hospitals in Spain.

Patients

Intensive care unit patients requiring triple-lumen central venous catheter for more than 3 days.

Interventions

At catheter insertion, 228 patients were randomized to minocycline and rifampin-impregnated catheters and 237 to non-impregnated catheters. Skin, catheter tip, subcutaneous segment, hub cultures, peripheral blood and infusate cultures were performed at catheter withdrawal. The rate of colonization, catheter-related bloodstream infection (CRBSI) and catheter-related clinical infectious complications (purulence at the insertion site or CRBSI) were assessed.

Measurements and main results

In the intention-to-treat analysis (primary analysis), the episodes per 1000 catheter days of clinical infectious complications decreased from 8.6 to 5.7 (RR =0.67, 95% CI 0.31–1.44), CRBSI from 5.9 to 3.1 (RR =0.53, 95% CI 0.2–1.44) and tip colonization from 24 to 10.4 (RR =0.43, 95% CI 0.26–0.73). Antimicrobial-impregnated catheters were associated with a significant decrease of coagulase-negative staphylococci colonization (RR =0.24, 95% CI 0.13–0.45) and a significant increase of Candida spp. colonization (RR =5.84, 95% CI 1.31–26.1).

Conclusions

The use of antimicrobial-impregnated catheters was associated with a significantly lower rate of coagulase-negative staphylococci colonization and a significant increase in Candida spp. colonization, although a decrease in CRBSI, increase in 30-day survival or reduced length of stay was not observed.

Keywords

Central venous catheters Minocycline and rifampin-impregnated catheters Non-impregnated catheters Rate of colonization Bloodstream infection Clinical infectious complications 

Supplementary material

supp.pdf (39 kb)
(PDF 40 KB)

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Cristóbal León
    • 1
  • Sergio Ruiz-Santana
    • 2
  • Jordi Rello
    • 3
  • Maria V. de la Torre
    • 4
  • Jordi Vallés
    • 5
  • Francisco Álvarez-Lerma
    • 6
  • Rafael Sierra
    • 7
  • Pedro Saavedra
    • 8
  • Francisco Álvarez-Salgado
    • 2
  • for the Cabaña Study Group
  1. 1.Intensive Care Unit, Hospital Universitario de ValmeUniversidad de SevillaSevillaSpain
  2. 2.Intensive Care Unit, Hospital Universitario Dr. NegrínUniversidad de Las Palmas de Gran CanariaLas Palmas de Gran CanariaSpain
  3. 3.Intensive Care Unit, Hospital Universitari Joan XXIIIUniversitat Rovira i VirgiliTarragonaSpain
  4. 4.Intensive Care UnitHospital Ntra. Sra. de la VictoriaMálagaSpain
  5. 5.Intensive Care UnitHospital Parc TaulíBarcelonaSpain
  6. 6.Intensive Care Unit, Hospital Universitari del Mar Universitat Autònoma de BarcelonaBarcelonaSpain
  7. 7.Intensive Care Unit, Hospital Universitario Puerta del MarUniversidad de CádizCádizSpain
  8. 8.Mathematics DepartmentUniversidad de Las Palmas de Gran CanariaLas Palmas de Gran CanariaSpain