Cloxacillin as an antibiotic lock solution for prevention of catheter-associated infection

Abstract

Introduction: Catheter-related infection is associated with increased all-cause mortality and morbidity in hemodialysis patients. This study aimed to evaluate an antimicrobial lock solution (cloxacillin and heparin) in temporary noncuffed double-lumen catheters for long-term intermittent hemodialysis as a method of preventing catheter-related infection.

Materials and methods: Patients on hemodialysis with noncuffed temporary double lumen catheter were randomly divided into 2 groups. Fifty patients received a solution containing cloxacillin, 100 mg/mL, plus heparin, 1000 IU/mL as a 2.5-mL solution instilled in each of catheter lumens after dialysis session. Another 50 patients received only heparin. They were allowed to dwell until the next session of dialysis.

Results: One catheter-related bacteremia was observed in the antibiotic group whereas catheter-related bacteremia was observed in 8 of those who received heparin only. The rate of catheter-related bacteremia episodes were 0.5 per 1000 catheter-days in the antibiotic group versus 7.8 per 1000 catheter-days in the control group (P = .02).

Conclusions: In the present study, application of cloxacillin as antibiotic lock solution for dialysis catheters resulted in a considerable reduction in catheter-related bacteremia rate.