A RANDOMIZED, CONTROLLED TRIAL OF THE EFFICACY OF A HEPARIN AND VANCOMYCIN SOLUTION IN PREVENTING CENTRAL VENOUS CATHETER INFECTIONS IN CHILDREN

Objective: To determine whether adding vancomycin to central venous ca theter (CVC) flush solution would significantly reduce the incidence o f bacteremia attributable to luminal colonization with vancomycin-susc eptible organisms. Study design: Fifty-five children with cancer and e ight children given total parenteral nutrition by the surgery or nutri tion support services were randomly assigned to receive a heparin CVC flush solution (n = 31) or a heparin-vancomycin CVC flush solution (n = 32). Results: During 9158 catheter days, 6.5% of the patients in the heparin group and 15.6% of the patients in the heparin-vancomycin gro up had bacteremia attributable to luminal colonization with vancomycin -susceptible organisms (p = 0.43). The mean rates of bacteremia attrib utable to luminal colonization with vancomycin-susceptible organisms w ere 0.6/1000 catheter days in the heparin group and 1.4/1000 catheter days in the heparin-vancomycin group (p = 0.25). There was no signific ant difference between the groups when the time to the first episode o f bacteremia attributable to luminal colonization with a vancomycin-su sceptible organism was compared by means of Kaplan-Meier survival esti mates. Streptococcus viridans infection was not attributable to lumina l colonization. Conclusion: The addition of vancomycin to heparin CVC flush solution did not reduce bacteremia with vancomycin-susceptible o rganisms. Bacteremia with Streptococcus viridans was not related to th e use of a CVC.