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dc.contributor.authorWalz, J. Matthias
dc.contributor.authorAvelar, Rui L.
dc.contributor.authorLongtine, Karen J.
dc.contributor.authorCarter, Kent L.
dc.contributor.authorMermel, Leonard A.
dc.contributor.authorHeard, Stephen O.
dc.contributor.author5-FU Catheter Study Group
dc.contributor.authorFaris, Khaldoun
dc.contributor.authorHall, Wiley R.
dc.contributor.authorOrquiola, Alan
dc.contributor.authorO'Neill, Melissa A.
dc.contributor.authorLongtine, Jaclyn K.
dc.date2022-08-11T08:07:58.000
dc.date.accessioned2022-08-23T15:37:41Z
dc.date.available2022-08-23T15:37:41Z
dc.date.issued2010-11-01
dc.date.submitted2012-08-01
dc.identifier.citation<p>Crit Care Med. 2010 Nov;38(11):2095-102. <a href="http://dx.doi.org/10.1097/CCM.0b013e3181f265ba" target="_blank">Link to article on publisher's site</a></p>
dc.identifier.issn0090-3493 (Linking)
dc.identifier.doi10.1097/CCM.0b013e3181f265ba
dc.identifier.pmid20711070
dc.identifier.urihttp://hdl.handle.net/20.500.14038/25774
dc.description<p>Khaldoun Faris, Wiley Hall, Alan Orquiola, Melissa O'Neill, and Jaclyn Longtine are coinvestigators from UMass Medical School in the 5-FU Study Group.</p>
dc.description.abstractOBJECTIVE: The antimetabolite drug, 5-fluorouracil, inhibits microbial growth. Coating of central venous catheters with 5-fluorouracil may reduce the risk of catheter infection. Our objective was to compare the safety and efficacy of central venous catheters externally coated with 5-fluorouracil with those coated with chlorhexidine and silver sulfadiazine. DESIGN: Prospective, single-blind, randomized, active-controlled, multicentered, noninferiority trial. SETTING: Twenty-five US medical center intensive care units. PATIENTS: A total of 960 adult patients requiring central venous catheterization for up to 28 days. INTERVENTIONS: Patients were randomized to receive a central venous catheter externally coated with either 5-fluorouracil (n = 480) or chlorhexidine and silver sulfadiazine (n = 480). MEASUREMENTS AND MAIN RESULTS: The primary antimicrobial outcome was a dichotomous measure (/= 15 colony-forming units) for catheter colonization determined by the roll plate method. Secondary antimicrobial outcomes included local site infection and catheter-related bloodstream infection. Central venous catheters coated with 5-fluorouracil were noninferior to chlorhexidine and silver sulfadiazine coated central venous catheters with respect to the incidence of catheter colonization (2.9% vs. 5.3%, respectively). Local site infection occurred in 1.4% of the 5-fluorouracil group and 0.9% of the chlorhexidine and silver sulfadiazine group. No episode of catheter-related bloodstream infection occurred in the 5-fluorouracil group, whereas two episodes were noted in the chlorhexidine and silver sulfadiazine group. Only Gram-positive organisms were cultured from 5-fluorouracil catheters, whereas Gram-positive bacteria, Gram-negative bacteria, and Candida were cultured from the chlorhexidine and silver sulfadiazine central venous catheters. Adverse events were comparable between the two central venous catheter coatings. CONCLUSIONS: Our results suggest that central venous catheters externally coated with 5-fluorouracil are a safe and effective alternative to catheters externally coated with chlorhexidine and silver sulfadiazine when used in critically ill patients.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20711070&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1097/CCM.0b013e3181f265ba
dc.subjectAnti-Infective Agents, Local
dc.subjectAntibiotic Prophylaxis
dc.subjectAntimetabolites
dc.subjectCatheter-Related Infections
dc.subjectCatheterization, Central Venous
dc.subjectCatheters, Indwelling
dc.subjectChlorhexidine
dc.subjectColony Count, Microbial
dc.subjectFemale
dc.subjectFluorouracil
dc.subjectHumans
dc.subjectIntensive Care
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProspective Studies
dc.subjectSilver Sulfadiazine
dc.subjectSingle-Blind Method
dc.subjectTreatment Outcome
dc.subjectAnesthesiology
dc.titleAnti-infective external coating of central venous catheters: a randomized, noninferiority trial comparing 5-fluorouracil with chlorhexidine/silver sulfadiazine in preventing catheter colonization
dc.typeJournal Article
dc.source.journaltitleCritical care medicine
dc.source.volume38
dc.source.issue11
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/anesthesiology_pubs/19
dc.identifier.contextkey3168551
html.description.abstract<p>OBJECTIVE: The antimetabolite drug, 5-fluorouracil, inhibits microbial growth. Coating of central venous catheters with 5-fluorouracil may reduce the risk of catheter infection. Our objective was to compare the safety and efficacy of central venous catheters externally coated with 5-fluorouracil with those coated with chlorhexidine and silver sulfadiazine.</p> <p>DESIGN: Prospective, single-blind, randomized, active-controlled, multicentered, noninferiority trial.</p> <p>SETTING: Twenty-five US medical center intensive care units.</p> <p>PATIENTS: A total of 960 adult patients requiring central venous catheterization for up to 28 days.</p> <p>INTERVENTIONS: Patients were randomized to receive a central venous catheter externally coated with either 5-fluorouracil (n = 480) or chlorhexidine and silver sulfadiazine (n = 480).</p> <p>MEASUREMENTS AND MAIN RESULTS: The primary antimicrobial outcome was a dichotomous measure (/= 15 colony-forming units) for catheter colonization determined by the roll plate method. Secondary antimicrobial outcomes included local site infection and catheter-related bloodstream infection. Central venous catheters coated with 5-fluorouracil were noninferior to chlorhexidine and silver sulfadiazine coated central venous catheters with respect to the incidence of catheter colonization (2.9% vs. 5.3%, respectively). Local site infection occurred in 1.4% of the 5-fluorouracil group and 0.9% of the chlorhexidine and silver sulfadiazine group. No episode of catheter-related bloodstream infection occurred in the 5-fluorouracil group, whereas two episodes were noted in the chlorhexidine and silver sulfadiazine group. Only Gram-positive organisms were cultured from 5-fluorouracil catheters, whereas Gram-positive bacteria, Gram-negative bacteria, and Candida were cultured from the chlorhexidine and silver sulfadiazine central venous catheters. Adverse events were comparable between the two central venous catheter coatings.</p> <p>CONCLUSIONS: Our results suggest that central venous catheters externally coated with 5-fluorouracil are a safe and effective alternative to catheters externally coated with chlorhexidine and silver sulfadiazine when used in critically ill patients.</p>
dc.identifier.submissionpathanesthesiology_pubs/19
dc.contributor.departmentDepartment of Surgery
dc.contributor.departmentDepartment of Anesthesiology
dc.source.pages2095-102


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