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© SICS EBM Group 2004
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Do antiseptic coated central lines prevent catheter-related bloodstream infection?
Lead author's name: C Logghe
Three-part Clinical Question: Patients: leukaemic patients 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: Randomised, controlled trial, with intention-to treat analysis
The Study Patients: 680 catheters in 538 patients
Control group (standard CVC) n=342 catheters;
all analysed Experimental group (impregnated CVC) n=338 catheters, all analysed
The Evidence:
EBM questions:
1) Do the methods allow accurate testing of the hypothesis? Yes, a power study indicated that 664 catheter insertions needed to be studied to detect an ARR of 4%
2) Do the statistical tests correctly test the results to allow differentiation of statistically significant results? Yes
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? 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? Perhaps, it depends on the generalisability of this study of leukaemic patients to your practice
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. June 2005
Email: d.g.swann@ad.ac.uk
Edited by CC Kill by Date: 2010
©SICS EBMG 2002
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