Treatment of central venous silastic catheter infections using hydrochloric acid

Patients receiving long-term home parenteral nutrition through a subcutaneously tunnelled central venous silastic catheter underwent a trial of 1.5 ml of 2M hydrochloric acid instilled into the catheter each time an episode of catheter sepsis was diagnosed. Four patients had eleven episodes of central venous catheter infection, with the hydrochloric acid clearing the infection on seven occasions, and unblocking the catheter once. The mainstay of therapy for catheter sepsis is removal of the catheter. However, in patients with subcutaneously tunnelled central venous silastic catheters, if reinserting the catheter is anticipated to be a major problem then a small dose of hydrochloric acid in an attempt to clear the infection may be worth a trial.