Skip to main content

Advertisement

SpringerLink
Log in

A simplified method of antibiotic lock therapy for Broviac–Hickman catheters using a CLC 2000 connector device

  • Short Communication
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Introduction

We report a simplified method of performing antibiotic lock therapy (ALT) based on a disposable central venous catheter (CVC) hub device, CLC 2000, enabling an open-ended CVC to be flushed with normal saline solution without heparin.

Methods

ALT was administered through a CLC 2000 connector for recurrent CVC-bloodstream infections (BSI) by the same organism in four patients and for CVC colonization in five patients.

Results

The antibiotic concentration obtained in the lumen of the CVC with ALT was 2,500-fold higher than the minimum inhibiting concentration of targeted bacteria for patients treated with vancomycin, 2,500–80,000-fold higher for patients treated with teicoplanin, and 10,000-fold higher for the patient treated with amikacin. All CVC-BSIs treated with ALT resulted in complete clinical and microbiological responses. No case of malfunction in withdrawing or flushing the CVC and no precipitation during the administration of the antibiotic solution was observed. No recurrence of CVC-BSI or CVC colonization by the same organism was diagnosed during subsequent follow-up, despite the fact that all patients had further periods of severe neutropenia. At the last follow-up, three CVCs had been removed for other infections (fever of unknown origin in two; fungemia in one), four CVCs had been removed at the end of therapy, and one CVC is still in situ 20 months after ALT.

Conclusions

In conclusion, a course of ALT is feasible in cancer patients with infected but much-needed CVCs before resorting to removal. The use of the CLC 2000 connector device simplifies the procedure for preparation and administration of ALT without compromising its efficacy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Anthony TU, Rubin LG (1999) Stability of antibiotics used for antibiotic-lock treatment of infections of implantable venous devices (Ports). Antimicrob Agents Chemother 43:2074–2077

    PubMed  CAS  Google Scholar 

  2. Bouza E, Burillo A, Muñoz P (2002) Catheter-related infections: diagnosis and intravascular treatment. Clin Microbiol Infect 8:265–274

    Article  PubMed  CAS  Google Scholar 

  3. Carratalà J (2002) The antibiotic-lock technique for therapy of “highly needed” infected catheters. Clin Microbiol Infect 8:282–289

    Article  PubMed  Google Scholar 

  4. Cesaro S, Corrò R, Pelosin A et al (2004) A prospective survey on incidence and outcome of Broviac/Hickman catheter-related complications in pediatric patients affected by hematological and oncological diseases. Ann Hematol 83:183–188

    Article  PubMed  Google Scholar 

  5. Crnich CJ, Maki DG (2002) The promise of novel technology for the prevention of intravascular device-related bloodstream infection. I. Pathogenesis and short-term devices. Clin Infect Dis 34:1232–1242

    Article  PubMed  Google Scholar 

  6. Curtin J, Cormican M, Fleming G et al (2003) Linezolid compared with Eperezolid, Vancomycin, and Gentamicin in an in vitro model of antimicrobial lock therapy for Staphylococcus epidermidis central venous catheter-related biofilm infections. Antimicrob Agents Chemother 47:3145–3148

    Article  PubMed  CAS  Google Scholar 

  7. Droste JC, Jeraj HA, MacDonald A et al (2003) Stability and in vitro efficacy of antibiotic–heparin lock solutions potentially useful for treatment of central venous catheter-related sepsis. J Antimicrob Chemother 51:849–855

    Article  PubMed  CAS  Google Scholar 

  8. Fätkenheuer G, Cornely O, Seifert H (2002) Clinical management of catheter-related infections. Clin Microbiol Infect 8:545–550

    Article  PubMed  Google Scholar 

  9. Henrickson KJ, Axtell RA, Hoover SM et al (2000) Prevention of central venous catheter-related infections and thrombotic events in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solution: a randomized, multicenter, double-blind trial. J Clin Oncol 18:1269–1278

    PubMed  CAS  Google Scholar 

  10. Hughes WT, Armstrong D, Bodey GP et al (2002) 2002 guideline for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 34:730–751

    Article  PubMed  Google Scholar 

  11. Mermel LA, Farr MA, Sherertz RJ et al (2001) Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 32:1249–1272

    Article  PubMed  CAS  Google Scholar 

  12. Segarra-Newnham M, Martin-Cooper EM (2005) Antibiotic lock technique: a review of the literature. Ann Pharmacother 39:311–318

    Article  PubMed  Google Scholar 

  13. Vercaigne LM, Zelenitsky SA, Findlay I et al (2002) An in vitro evaluation of the antibiotic/heparin lock to sterilize central venous haemodialysis catheters. J Antimicrob Chemother 49:693–696

    Article  PubMed  CAS  Google Scholar 

  14. Warkentin TE, Levine MN, Hirsh J et al (1995) Heparin-induced thrombocytopenia in patients treated with low-molecular weight heparin or unfractionated heparin. N Engl J Med 332:1330–1335

    Article  PubMed  CAS  Google Scholar 

  15. Wenzel RP, Edmond MB (2001) The impact of hospital-acquired bloodstream infections. Emerg Infect Dis 7(2):174–177

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinic of Pediatric Hematology and Oncology, Department of Pediatrics, University of Padova, Via Giustiniani 3, 35128, Padova, Italy

    Simone Cesaro, Mara Cavaliere, Monica Spiller, Laura Magagna, Patrizia Gavin, Michela Bonetto & Modesto Carli

  2. Institute of Microbiology and Virology, University of Padua, Padova, Italy

    Lucia Rossi

Authors
  1. Simone Cesaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mara Cavaliere
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Monica Spiller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lucia Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laura Magagna
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Patrizia Gavin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michela Bonetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Modesto Carli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simone Cesaro.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cesaro, S., Cavaliere, M., Spiller, M. et al. A simplified method of antibiotic lock therapy for Broviac–Hickman catheters using a CLC 2000 connector device. Support Care Cancer 15, 95–99 (2007). https://doi.org/10.1007/s00520-006-0099-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-006-0099-5

Keywords

Search

Navigation