Anti-infective external coating of central venous catheters: a randomized, noninferiority trial comparing 5-fluorouracil with chlorhexidine/silver sulfadiazine in preventing catheter colonization
dc.contributor.author | Walz, J. Matthias | |
dc.contributor.author | Avelar, Rui L. | |
dc.contributor.author | Longtine, Karen J. | |
dc.contributor.author | Carter, Kent L. | |
dc.contributor.author | Mermel, Leonard A. | |
dc.contributor.author | Heard, Stephen O. | |
dc.contributor.author | 5-FU Catheter Study Group | |
dc.contributor.author | Faris, Khaldoun | |
dc.contributor.author | Hall, Wiley R. | |
dc.contributor.author | Orquiola, Alan | |
dc.contributor.author | O'Neill, Melissa A. | |
dc.contributor.author | Longtine, Jaclyn K. | |
dc.date | 2022-08-11T08:07:58.000 | |
dc.date.accessioned | 2022-08-23T15:37:41Z | |
dc.date.available | 2022-08-23T15:37:41Z | |
dc.date.issued | 2010-11-01 | |
dc.date.submitted | 2012-08-01 | |
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.issn | 0090-3493 (Linking) | |
dc.identifier.doi | 10.1097/CCM.0b013e3181f265ba | |
dc.identifier.pmid | 20711070 | |
dc.identifier.uri | http://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.abstract | 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. 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.iso | en_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.url | http://dx.doi.org/10.1097/CCM.0b013e3181f265ba | |
dc.subject | Anti-Infective Agents, Local | |
dc.subject | Antibiotic Prophylaxis | |
dc.subject | Antimetabolites | |
dc.subject | Catheter-Related Infections | |
dc.subject | Catheterization, Central Venous | |
dc.subject | Catheters, Indwelling | |
dc.subject | Chlorhexidine | |
dc.subject | Colony Count, Microbial | |
dc.subject | Female | |
dc.subject | Fluorouracil | |
dc.subject | Humans | |
dc.subject | Intensive Care | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Prospective Studies | |
dc.subject | Silver Sulfadiazine | |
dc.subject | Single-Blind Method | |
dc.subject | Treatment Outcome | |
dc.subject | Anesthesiology | |
dc.title | Anti-infective external coating of central venous catheters: a randomized, noninferiority trial comparing 5-fluorouracil with chlorhexidine/silver sulfadiazine in preventing catheter colonization | |
dc.type | Journal Article | |
dc.source.journaltitle | Critical care medicine | |
dc.source.volume | 38 | |
dc.source.issue | 11 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/anesthesiology_pubs/19 | |
dc.identifier.contextkey | 3168551 | |
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.submissionpath | anesthesiology_pubs/19 | |
dc.contributor.department | Department of Surgery | |
dc.contributor.department | Department of Anesthesiology | |
dc.source.pages | 2095-102 |