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Benefits of minocycline and rifampin-impregnated central venous catheters

A prospective, randomized, double-blind, controlled, multicenter trial

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Abstract

Objective

To determine the efficacy of minocycline and rifampin-impregnated catheters compared to non-impregnated catheters in critically ill patients.

Design

Prospective, randomized, double-blind, controlled, multicenter trial.

Setting

Intensive care units of seven acute-care teaching hospitals in Spain.

Patients

Intensive care unit patients requiring triple-lumen central venous catheter for more than 3 days.

Interventions

At catheter insertion, 228 patients were randomized to minocycline and rifampin-impregnated catheters and 237 to non-impregnated catheters. Skin, catheter tip, subcutaneous segment, hub cultures, peripheral blood and infusate cultures were performed at catheter withdrawal. The rate of colonization, catheter-related bloodstream infection (CRBSI) and catheter-related clinical infectious complications (purulence at the insertion site or CRBSI) were assessed.

Measurements and main results

In the intention-to-treat analysis (primary analysis), the episodes per 1000 catheter days of clinical infectious complications decreased from 8.6 to 5.7 (RR =0.67, 95% CI 0.31–1.44), CRBSI from 5.9 to 3.1 (RR =0.53, 95% CI 0.2–1.44) and tip colonization from 24 to 10.4 (RR =0.43, 95% CI 0.26–0.73). Antimicrobial-impregnated catheters were associated with a significant decrease of coagulase-negative staphylococci colonization (RR =0.24, 95% CI 0.13–0.45) and a significant increase of Candida spp. colonization (RR =5.84, 95% CI 1.31–26.1).

Conclusions

The use of antimicrobial-impregnated catheters was associated with a significantly lower rate of coagulase-negative staphylococci colonization and a significant increase in Candida spp. colonization, although a decrease in CRBSI, increase in 30-day survival or reduced length of stay was not observed.

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Acknowledgements>

We thank Marta Pulido, MD, for editing the manuscript and editorial assistance.

Author information

Authors and Affiliations

  1. Intensive Care Unit, Hospital Universitario de Valme, Universidad de Sevilla, Carretera de Cádiz s/n, 41014, Sevilla, Spain

    Cristóbal León

  2. Intensive Care Unit, Hospital Universitario Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

    Sergio Ruiz-Santana & Francisco Álvarez-Salgado

  3. Intensive Care Unit, Hospital Universitari Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain

    Jordi Rello

  4. Intensive Care Unit, Hospital Ntra. Sra. de la Victoria, Málaga, Spain

    Maria V. de la Torre

  5. Intensive Care Unit, Hospital Parc Taulí, Sabadell, Barcelona, Spain

    Jordi Vallés

  6. Intensive Care Unit, Hospital Universitari del Mar , Universitat Autònoma de Barcelona, Barcelona, Spain

    Francisco Álvarez-Lerma

  7. Intensive Care Unit, Hospital Universitario Puerta del Mar, Universidad de Cádiz, Cádiz, Spain

    Rafael Sierra

  8. Mathematics Department, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

    Pedro Saavedra

Authors
  1. Cristóbal León
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  2. Sergio Ruiz-Santana
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  3. Jordi Rello
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  4. Maria V. de la Torre
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  5. Jordi Vallés
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  6. Francisco Álvarez-Lerma
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  7. Rafael Sierra
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  8. Pedro Saavedra
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  9. Francisco Álvarez-Salgado
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Consortia

for the Cabaña Study Group

Corresponding author

Correspondence to Cristóbal León.

Additional information

This study was supported by a grant from Cook Europe.

Electronic Supplementary Material

Other members of the Cabaña Study Group

Other members of the Cabaña Study Group

Francisco Lucena, MD, Mario Márquez, MD, and José L. García, MD, Hospital Universitario de Valme, Sevilla; Juan J. Rodrigo, MD, and A. Bordes, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria; C. Ardanuy, MD, and C. Boqué, MD, Hospital Universitari Joan XXIII, Tarragona; I. Fernández, MD, and I. Viciana, MD, Hospital Clínico, Málaga; R. Ferrer, MD, and D. Mariscal, MD, Hospital Parc Taulí, Sabadell, Barcelona; M. Benazzuz, MD, and M.T. Torrella, MD, Hospital Universitari del Mar, Barcelona; A. Guerrero, MD, and P. Marín, MD, Hospital Puerta del Mar, Cádiz; E. Ramírez, MD, Hospital Clínico, Sevilla; and P. Pérez, MD, Cook España, Barcelona, Spain.

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León, C., Ruiz-Santana, S., Rello, J. et al. Benefits of minocycline and rifampin-impregnated central venous catheters. Intensive Care Med 30, 1891–1899 (2004). https://doi.org/10.1007/s00134-004-2378-2

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  • DOI: https://doi.org/10.1007/s00134-004-2378-2

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