Walz, J. MatthiasAvelar, Rui L.Longtine, Karen J.Carter, Kent L.Mermel, Leonard A.Heard, Stephen O.5-FU Catheter Study GroupFaris, KhaldounHall, Wiley R.Orquiola, AlanO'Neill, Melissa A.Longtine, Jaclyn K.2022-08-232022-08-232010-11-012012-08-01<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>0090-3493 (Linking)10.1097/CCM.0b013e3181f265ba20711070https://hdl.handle.net/20.500.14038/25774<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>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.en-USAnti-Infective Agents, LocalAntibiotic ProphylaxisAntimetabolitesCatheter-Related InfectionsCatheterization, Central VenousCatheters, IndwellingChlorhexidineColony Count, MicrobialFemaleFluorouracilHumansIntensive CareMaleMiddle AgedProspective StudiesSilver SulfadiazineSingle-Blind MethodTreatment OutcomeAnesthesiologyJournal Articlehttps://escholarship.umassmed.edu/anesthesiology_pubs/193168551anesthesiology_pubs/19