A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections

Steven Tennenberg, Mark Lieser, Brenda McCurdy, Gail Boomer, Ellen Howington, Cheryl L Newman, Irma Wolf

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Objective: To test the efficacy of the ARROWgard (Arrow International Inc, Reading, Pa) central venous catheter (CVC) coated with silver sulfadiazine and chlorhexidine (A-CVC) in the prevention of CVC-related infections. Design: Prospective, randomized trial. Setting: A tertiary care medical center. Patients and Intervention: Two hundred eighty-two patients who required CVC placement were evaluated in this study. Patients were prospectively randomized to receive either a standard CVC (S-CVC) or the A- CVC. Only fresh-stick double- and triple-lumen catheters were studied. Main Outcome Measures: Patients were evaluated for catheter site inflammation, catheter site colonization, local catheter-related infection, and catheter- related septicemia. Results: The 2 groups were matched for age, percentage in the intensive care unit, percentage receiving total parenteral nutrition, percentage with triple-lumen catheters, and duration of catheterization. Rates of catheter site inflammation in the 2 groups were similar (12% vs 10%, S-CVC group and A-CVC group, respectively). The A-CVC was associated with a significantly decreased catheter site colonization rate (49% vs 28%; 43% reduction; P<.001) and local catheter-related infection rate (22.4% vs 5.8%; 74% reduction; P<.001). Rates of catheter-related septicemia were reduced by 41% in the A-CVC group (6.4% vs 3.8%, S-CVC group and A-CVC group, respectively), but this was not statistically significant. Conclusions: Despite a marked decrease in catheter site colonization and catheter-related infection rates, the A-CVC did not significantly reduce the incidence of catheter-related septicemia. This maybe due to a greater pathogenic dependence on catheter hub contamination rather than catheter site colonization or local catheter-related infection, or the relatively short (5.2 days) duration of catheterization in this study.

Original languageEnglish (US)
Pages (from-to)1348-1351
Number of pages4
JournalArchives of Surgery
Volume132
Issue number12
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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Catheter-Related Infections
Local Anti-Infective Agents
Central Venous Catheters
Catheters
Anti-Bacterial Agents
Sepsis
Catheterization
Silver Sulfadiazine
Inflammation
Chlorhexidine
Total Parenteral Nutrition
Tertiary Care Centers
Intensive Care Units
Reading
Research Design

ASJC Scopus subject areas

  • Surgery

Cite this

A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections. / Tennenberg, Steven; Lieser, Mark; McCurdy, Brenda; Boomer, Gail; Howington, Ellen; Newman, Cheryl L; Wolf, Irma.

In: Archives of Surgery, Vol. 132, No. 12, 01.01.1997, p. 1348-1351.

Research output: Contribution to journalArticle

Tennenberg, Steven ; Lieser, Mark ; McCurdy, Brenda ; Boomer, Gail ; Howington, Ellen ; Newman, Cheryl L ; Wolf, Irma. / A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections. In: Archives of Surgery. 1997 ; Vol. 132, No. 12. pp. 1348-1351.
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abstract = "Objective: To test the efficacy of the ARROWgard (Arrow International Inc, Reading, Pa) central venous catheter (CVC) coated with silver sulfadiazine and chlorhexidine (A-CVC) in the prevention of CVC-related infections. Design: Prospective, randomized trial. Setting: A tertiary care medical center. Patients and Intervention: Two hundred eighty-two patients who required CVC placement were evaluated in this study. Patients were prospectively randomized to receive either a standard CVC (S-CVC) or the A- CVC. Only fresh-stick double- and triple-lumen catheters were studied. Main Outcome Measures: Patients were evaluated for catheter site inflammation, catheter site colonization, local catheter-related infection, and catheter- related septicemia. Results: The 2 groups were matched for age, percentage in the intensive care unit, percentage receiving total parenteral nutrition, percentage with triple-lumen catheters, and duration of catheterization. Rates of catheter site inflammation in the 2 groups were similar (12{\%} vs 10{\%}, S-CVC group and A-CVC group, respectively). The A-CVC was associated with a significantly decreased catheter site colonization rate (49{\%} vs 28{\%}; 43{\%} reduction; P<.001) and local catheter-related infection rate (22.4{\%} vs 5.8{\%}; 74{\%} reduction; P<.001). Rates of catheter-related septicemia were reduced by 41{\%} in the A-CVC group (6.4{\%} vs 3.8{\%}, S-CVC group and A-CVC group, respectively), but this was not statistically significant. Conclusions: Despite a marked decrease in catheter site colonization and catheter-related infection rates, the A-CVC did not significantly reduce the incidence of catheter-related septicemia. This maybe due to a greater pathogenic dependence on catheter hub contamination rather than catheter site colonization or local catheter-related infection, or the relatively short (5.2 days) duration of catheterization in this study.",
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T1 - A prospective randomized trial of an antibiotic- and antiseptic-coated central venous catheter in the prevention of catheter-related infections

AU - Tennenberg, Steven

AU - Lieser, Mark

AU - McCurdy, Brenda

AU - Boomer, Gail

AU - Howington, Ellen

AU - Newman, Cheryl L

AU - Wolf, Irma

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