Effectiveness of silver sulfadiazine-coated catheters in preventing thrombophlebitis in hospitalized foals

Sick neonatal foals often need venous catheters, which can lead to thrombosis and infection. In human medicine, antimicrobial-coated catheters are widely used to prevent catheter bacterial colonization and catheter-related infections.

The aim was to assess the occurrence and risk factors for thrombophlebitis in hospitalized foals and determine whether using antimicrobial silver sulfadiazine (SS)-coated catheters prevented this condition.

A total of 170 hospitalized foals received a jugular venous over-the-wire long-term catheter.

Open-label randomized controlled trial. Foals were randomly assigned to either the SS-coated catheter group or the standard (ST) catheter group, and thrombophlebitis occurrence was compared using the chi-square test. The time to thrombophlebitis development was assessed using Kaplan-Meier methods. A penalized logistic regression using the least absolute shrinkage and selection operator (LASSO) was performed to identify risk factors.

The study involved 83 foals in the SS group and 87 in the ST group. Thrombophlebitis occurred in 19.4% of cases, with 23.0% in the ST group and 15.7% in the SS group, although this difference was not statistically significant (P-value = .23). Silver sulfadiazine group foals developed thrombophlebitis later than the ST group (5 days vs 3 days, log-rank test: P-value = .015). The risk factors for the development of thrombophlebitis included age under 3 days, the presence of diarrhea, the presence of fever, administration of low-molecular-weight heparin, and a catheter dwell time of 19 days, while a higher placement score was protective against thrombophlebitis.

Silver sulfadiazine-coated catheters delay thrombophlebitis development and are well tolerated.