Antimicrobial-coated/bonded and -impregnated intravascular catheters

Area of Science:

• Infectious Diseases
• Medical Devices
• Public Health

Background:

• Catheter-related bloodstream infections (CRBIs) are a significant cause of morbidity and mortality.
• Antimicrobial-coated and -impregnated intravascular catheters are developed to prevent CRBIs.
• Existing preventative measures have shown varying degrees of success.

Purpose of the Study:

• To review the literature on the efficacy of antimicrobial-coated/bonded and -impregnated intravascular catheters in preventing catheter colonization and CRBIs.
• To compare the effectiveness of different antimicrobial catheter coatings.

Main Methods:

• A comprehensive literature search was conducted using MEDLINE (1966-September 2000) and other relevant sources.
• Key search terms included antibiotic, antimicrobial, antiseptic, silver, and various catheter modifications.
• All identified English-language primary and review articles were evaluated for relevance.

Main Results:

• While some antimicrobial catheters showed limited success, a meta-analysis indicated a statistically significant reduction in CRBIs with chlorhexidine-silver sulfadiazine (C-SS) catheters.
• Minocycline-rifampin (M-R) catheters demonstrated a larger reduction in CRBIs compared to C-SS catheters.
• The use of M-R and C-SS catheters for short-term (<7 days) catheterization may lead to substantial cost savings and a reduction in CRBI-related deaths.

Conclusions:

• Minocycline-rifampin (M-R) catheters appear to be more effective than C-SS catheters in preventing CRBIs during short-term catheterization.
• The implementation of M-R catheters is anticipated to result in significant cost savings and a reduction in mortality associated with CRBIs.