Antimicrobial Lock Therapy in Clinical Practice: A Scoping Review

Antimicrobial lock therapy (ALT) prevents microbial colonization in central vein catheters and treats existing catheter-related bloodstream infections (CRBSIs); the ALT assessment involves several key considerations. First, identifying which patients are suitable candidates is crucial. Additionally, understanding the clinical contexts in which is utilised provides insight into its applications. Examining when ALT has been employed and analyzing trends in its use over time can highlight its evolving role in patient care. Equally important is understanding how ALT is administered, including the specific agents used. Lastly, determining whether there is sufficient existing literature is essential to evaluate the feasibility of conducting future systematic reviews. This study is a scoping review adhered to the PRISMA-ScR guidelines and followed a five-stage methodological framework. Of the 1024 studies identified, 336 were included in the analysis. Findings highlight the widespread use of ethanol and taurolidine for CRBSIs prevention and the concurrent use of ALT with systemic antimicrobials to treat CRBSIs without catheter removal. ALT improves clinical outcomes, including post-infection survival and catheter retention. From our analysis, we have concluded that both an umbrella review of systematic reviews and a network meta-analysis comparing lock solutions can provide clearer guidance for clinical practice.