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© SICS EBM Group 2004
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Do antiseptic coated central lines prevent catheter-related bloodstream infection?
Citation: Antiseptic-bonded central venous catheters and bacterial colonisation Anaesthesia, 1999; 54: 868-872 Lead author's name: Hannan M
Three-part Clinical Question: Patients: intensive care patients Intervention: antiseptic coated (silver sulphadiazine and chlorhexidine) or untreated central venous catheters Outcomes: catheter colonisation and catheter-related sepsis. (either definite, probable, possible or negative) Definite catheter-related sepsis equated to CRBSI.
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: 351 catheters were placed in 228 patients.
Control group (standard CVC) n = 177; all analysed
The Evidence:
EBM questions:
1) Do the methods allow accurate testing of the hypothesis? No, the study was under-powered to detect a difference in catheter-related sepsis. After the study the authors estimated that 1080 catheter placements would need to be studied to detect a statistically significant reduction in sepsis rates. Many more would be required to detect a difference in CRBSI.
2) Do the statistical tests correctly test the results to allow differentiation of statistically significant results? No, power calculation was done before the study. While the sample size was good for looking at differences in catheter colonisation, it was too small to detect any significant difference in CRBSI.
3) Are conclusions valid in light of the results? Only in regard to the reduced colonisation rate of antiseptic catheters. The authors implied that this would logically result in a reduced CRBSI rate , but they have failed to demonstrate this.
4) Did results get omitted, and why? No
5) Did they suggest areas of further research? No
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
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. June 2005 .
Email: d.g.swann@ad.ac.uk
Edited by CC
Kill by Date: 2010
©SICS EBMG 2005
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