Antibiotic lock technique: review of the literature

Central venous catheters (CVCs) are frequently used for patients requiring long-term venous access. Catheter-related infection is a serious complication associated with extended use of a CVC and can result in catheter removal. The antibiotic lock technique, a controversial method for sterilizing the catheter lumen, involves instilling high concentrations of antibiotics with or without heparin into the catheter lumen for extended periods of time. Studies differ regarding the choice and concentrations of antibiotics, dwell times in the catheter lumen, presence of heparin in the antibiotic lock technique solution, use of systemic antibiotics with the technique, and use of the technique for prevention or treatment of catheter-related infections. Results of in vitro studies demonstrate that many antibiotic combinations are stable and maintain high drug concentrations for prolonged periods of time. In vivo studies report the success of multiple combinations for both prevention and treatment with antibiotic lock technique in salvaging these catheters.