TOTALLY IMPLANTED CATHETERS TO REDUCE CATHETER-RELATED INFECTIONS IN PATIENTS RECEIVING INTERLEUKIN-2 - A 2-YEAR EXPERIENCE

A high incidence of bacterial infections has been previously reported during interleukin-2 (IL-2) treatment, mainly due to catheter-related infections. Antibiotic prophylaxis has been successfully used to decre ase such infections. The goal of this study was to evaluate an alterna tive way to reduce catheter-related infections in IL-2-treated patient s by the use of totally implanted catheters. A total of 74 patients wi th metastatic renal cell carcinoma, referred to our institution to rec eive IL-2 from March 1989 to July 1991, were included in this prospect ive study. IL-2 was given on a 2-days-a-week schedule (24 x 10(6) IU m (-2) day(-1)) either alone (41 patients) or in association with interf eron gamma (33 patients). All these patients were prospectively evalua ted for fever, bacteremia and line-site infection. Seven patients (9.5 %) had one (2 patients) or more (5 patients) positive blood cultures w ith Staphylococcus aureus. Antibiotics were used only in 5 patients, a nd the catheter had to be removed in only 2 of these patients. In the other patients, no further infection developed despite the lack of ant ibiotics. Moreover, 9 patients had positive blood cultures with Staphy lococcus epidermidis (1.9% of total number of blood cultures). In conc lusion, a totally implanted catheter appears to reduce the incidence o f infections in IL-2-treated patients, at least on a 2-days-a-week sch edule.