Supportive Care in Cancer

, Volume 13, Issue 12, pp 993–1000 | Cite as

Chlorhexidine and silver-sulfadiazine coated central venous catheters in haematological patients—a double-blind, randomised, prospective, controlled trial

  • Torben Ostendorf
  • Andrea Meinhold
  • Christoph Harter
  • Hans Salwender
  • Gerlinde Egerer
  • Heinrich K. Geiss
  • Antony D. Ho
  • Hartmut Goldschmidt
Original Article

Abstract

Background

Central venous catheters (CVCs) are essential for the intensive care of patients with haematological illness. Catheter-related infections (CRI) are an important problem in modern medicine, which may lead to life-threatening situations, to prolonged hospitalisation and increased cost. In immunocompromised patients suffering from haemato-oncological diseases, CRI is a significant factor for adverse outcome. Several clinical studies have shown that CVCs coated with antiseptics such as chlorhexidine and silver-sulfadiazine (CHSS) reduce the risk of catheter-related bacteraemia. Most studies, however, were performed on intensive care patients not suffering from chemotherapy-induced immunosuppression.

Patients and methods

A prospective double-blind, randomised, controlled trial was performed to investigate the effectiveness of CHSS-coated catheters in haemato-oncological patients. A total number of 184 catheters (median duration of placement, 11 days) were inserted into 184 patients (male 115, female 69), of which 90 were antiseptically coated. After removal, all catheters were investigated for bacterial growth.

Main results

Catheters coated with CHSS were effective in reducing the rate of significant bacterial growth on either the tip or subcutaneous segment (26%) compared to control catheters (49%). The incidence of catheter colonisation was also significantly reduced (12% coated vs 33% uncoated). Data obtained show a significant reduction of catheter colonisation in CHSS catheters. There was no significant difference in the incidence of catheter-related bacteraemia (3% coated vs 7% uncoated). However, due to the overall low rate of CRI, we could not observe a significant reduction in the incidence of catheter-related bacteraemia.

Conclusion

Our data show that the use of CHSS catheters in patients with haematological malignancy reduces the overall risk of catheter colonisation and CRI, although the incidence of catheter-related bacteremia was similar in both groups.

Keywords

Central venous catheter Chlorhexidine Silver sulfadiazine Catheter-related infection Haematologic–oncologic patients 

Notes

Acknowledgements

Support of this study was provided by ARROW International, Reading, PA, USA (Jan Bovelander). The authors thank the nursing staff of the Department of Internal Medicine V for their excellent care of the patients.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Torben Ostendorf
    • 1
  • Andrea Meinhold
    • 1
  • Christoph Harter
    • 1
    • 4
  • Hans Salwender
    • 2
  • Gerlinde Egerer
    • 1
  • Heinrich K. Geiss
    • 3
  • Antony D. Ho
    • 1
  • Hartmut Goldschmidt
    • 1
  1. 1.Department of Internal Medicine VUniversity of HeidelbergHeidelbergGermany
  2. 2.Department of HaematologyAllgemeines Krankenhaus AltonaHamburgGermany
  3. 3.Department of Medical Microbiology and HygieneInstitute of HygieneUniversity of HeidelbergHeidelbergGermany
  4. 4.Medizinische Klinik–Abteilung Innere Medizin VHeidelbergGermany

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