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Do antiseptic coated central lines prevent catheter-related bloodstream infection?

Citation: Bach A, et al. Retention of antibacterial activity and bacterial colonization of antiseptic-bonded central venous catheters. Journal of Antimicrobial Chemotherapy, 1996; 37: 315-322

Lead author's name: Bach A

Three-part Clinical Question:

Patients: in cardiac surgical intensive care

Intervention: Antiseptic impregnation with silver sulphadiazine and chlorhexidine or untreated central venous catheters

Outcomes: catheter colonisation and catheter related bloodstream infection (CRBSI)

Search Terms: intensive care, critical care, central venous catheters, infection, prevention, controlled trial

The Study: Blinded randomised controlled trial with intention-to treat analysis.

The Study Patients:

Control group n= 117; all analysed. Non-impregnated CVCs.
Experimental group n= 116; all analysed. Silver sulphadiazine and chlorhexidine impregnated CVCs.

The Evidence:

EBM Comments:

1) Do the methods allow accurate testing of the hypothesis? Yes, the authors’ primary aim was to analyse catheter colonisation.

2) Do the statistical tests correctly test the results to allow differentiation of statistically significant results? Yes, though the study was not powered to detect differences in CRBSI

3) Are conclusions valid in light of the results? Yes

4) Did results get omitted, and why? No

5) Did they suggest areas of further research? Yes – further prospective studies with CRBSIs as a primary outcome

6) Did they make any recommendations based on the results and were they appropriate? No

7) Is the study relevant to my clinical practice? Yes, especially if you look after cardiac surgery patients.

8) What level of evidence does this study represent? 1^-

9) What grade of recommendation can I make on this result alone? N/A

10) What grade of recommendation can I make when this study is considered

along with other available evidence? A – see topic summary

11) Should I change my practice because of these results? Perhaps- it depends on your views about the validity and importance of pooled analysis of RCTs

12) Should I audit my current practice because of these results? No, but you should be auditing CRBSI rates anyway

Appraised by Dr David Swann, Consultant, ICU, Royal Infirmary of Edinburgh.  

Email: d.g.swann@ad.ac.uk

Edited by CC 

June 2005 

Kill by Date: 2010 

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