Intravenous catheter infection study: a prospective trial in patients with neoplastic disease

This study was designed to determine the frequency and significance of infection at the site of indwelling intravenous catheters. Eligible patients were randomly assigned to have an intravenous infusion utilizing either a plastic cannula or or a short metal needle. Both of these groups were further randomly divided into two groups, one having the intravenous catheter removed every 48 hr and the other having the catheter changed only when necessary. One hundred and eighty-seven catheters from 50 patients were cultured. Eleven (5.9%) of the catheters were found to be colonized by organisms. Metal needles and plastic cannulas were infected with similar frequency. The incidence of local infection was not influenced by concurrent antibiotic therpy, local phlebitis, or the level of the granulocyte count during the period of intravenous infusion. Six of 31 catheter tips in place for longer than 56 hr were colonized by organisms, compared with 5 of 156 catheter tips in place for less than 56 hr (p less than 0.0001). The study indicates that indwelling intravenous catheters should be changed at least every 48 hr in order to prevent colonization of the tip of the intravenous catheter.