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

Citation: A Prospective Randomized Trial of an Antibiotic- and Antiseptic-Coated Central Venous Catheter in the Prevention of Catheter-Related Infections. Archives of Surgery 1997; 132: 1348-1351

Lead author's name: Tennenberg S

Three-part Clinical Question:

Patients: hospital patients

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

Outcomes: catheter colonisation and catheter-related septicaemia (CRS). The latter depended on the isolation of bacteria from blood obtained from the central venous catheter alone. Catheter colonization cannot be differentiated from CRBSI using these critieria

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

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

The Study Patients: 352 patients were enrolled with 70 excluded from analysis for various reasons.

Control group (standard CVC) n=145 catheters in 145 patients

Experimental group (impregnated CVC) n=137 catheters in 137 patients

The Evidence:

EBM questions:

1) Do the methods allow accurate testing of the hypothesis? No. As explained, the diagnostic end-points used do not comply with conventional definitions of CRBSI

2) Do the statistical tests correctly test the results to allow differentiation of statistically significant results? Yes a power study using Maki’s data was done

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

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

5) Did they suggest areas of further research? Yes, a larger study

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

No

7) Is the study relevant to my clinical practice? No, included all hospital 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. June 2005 

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

Edited by CC 

Kill by Date: 2010 

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