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© SICS EBM Group 2004
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Do antibiotic-impregnated central lines prevent catheter-related bloodstream infection?
Citation: Benefits of minocycline and rifampin-impregnated central venous catheters Lead author's name: León C
Three-part Clinical Question: Patients: intensive care patients Intervention: antibiotic impregnation minocycline and rifampin or untreated central venous catheters Outcomes: catheter colonisation and catheter related bloodstream infection (CRBSI)
Search Terms: Central venous catheters, Minocycline and rifampin-impregnated catheters, Bloodstream infection, Infectious complications
The Study: Randomised, double-blind controlled trial with intention-to treat analysis
The Study Patients: 465 patients Control group (standard CVC) n= 237; 180
analysed Experimental group (impregnated CVC) n=228; 187 analysed
The Evidence:
EBM questions:
1) Do the methods allow accurate testing of the hypothesis? Yes.
2) Do the statistical tests correctly test the results to allow differentiation of statistically significant results? No, the authors used data from Raad’s study to calculate that 302 patients were needed to detect a significant difference in infection rates between the two groups. However their experimental patients had a higher rate of CRBSIs than the previous study, so that this study may have been under-powered. The authors calculated that 1648 patients would be needed given their findings.
3) Are conclusions valid in light of the results?Yes
4) Did results get omitted, and why? Yes
5) Did they suggest areas of further research? No
6) Did they make any recommendations based on the results and were they appropriate? Yes, antibiotic impregnated catheters may be of most use when the incidence of CRBSI is high.
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? B
10) What grade of recommendation can I make when this study is considered along with other available evidence? B
11) Should I change my practice because of these results? Probably not
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. June 2005
Email: d.g.swann@ad.ac.uk
Edited by CC Kill by Date: 2010
©SICS EBMG 2002
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