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

Citation: Antiseptic-impregnated central venous catheters reduce the incidence of bacterial colonization and associated infection in immunocompromised transplant patients.European Journal of Anaesthesiology 1997; 14: 428-31

 Lead author's name: George SJ

Three-part Clinical Question:

Patients: with solid organ transplant

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

Outcomes: catheter colonisation and “associated infections”

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

The Study:Randomised, controlled trial, without intention-to treat analysis.

The Study Patients: 79 catheters in 60 patients, an additional 7 catheters were lost to the study.

Control group (standard catheters) n=35 catheters

Experimental group (impregnated catheters) n=44 catheters.

The Evidence:

EBM questions:

1) Do the methods allow accurate testing of the hypothesis? No, the study looked at “associated” infection rates. These were defined as infection at another site, by the same organism isolated from the central venous catheter. The sites included urine, another line and blood. Only CRBSIs are reasonable, important outcomes.

2) Do the statistical tests correctly test the results to allow differentiation of statistically significant results? No, a power study was not done. It is likely that a type II error resulted in the failure to demonstrate statistically significant differences in CRBSIs.

3) Are conclusions valid in light of the results? No

4) Did results get omitted, and why? Yes, some patients were lost because of protocol violations.

5) Did they suggest areas of further research? No.

6) Did they make any recommendations based on the results and were they appropriate? Yes

7) Is the study relevant to my clinical practice? Yes, if you look after transplant 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

11) Should I change my practice because of these results? No

12) Should I audit my current practice because of these results? No

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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