REDUCED INTRAVASCULAR CATHETER-RELATED INFECTION BY ROUTINE USE OF ANTIBIOTIC-BONDED CATHETERS IN A SURGICAL INTENSIVE-CARE UNIT

We report a comparative analysis of intravascular catheter-related inf ection before and after routine use of antibiotic-bonded catheters in an intensive care unit. Cefazolin-bonded catheters were placed in pati ents requiring catheterization for at least 3 days, or with remote inf ection, standard catheters at other times. One thousand forty-five cat heters (259 patients) over 6 months were compared with 801 (236 antibi otic-bonded, 565 standard) catheters (239 patients) the next 6 months. After use of antibiotic-bonded catheters, we found: 1.7% catheters in fected versus 3.7% (p = 0.01); catheter-associated bacteremia 0.1% ver sus 1.3% (p < 0.005); catheter-related infection rate 4.39 versus 10.7 3 per 1000 patient days (p < 0.005), and 5.06 versus 11.47 per 1000 ca theter days (p < 0.01); and cumulative risk of infection decreased (p < 0.005). Antibiotic-bonded catheters were used with more remote infec tions (52% versus 27%, p < 0.001), had longer indwelling time (4.4 ver sus 3.1 days, p = 0.001), and more were inserted over a guide wire (66 % vs. 28%, p < 0.001). In conclusion, routine use of antibiotic-bonded catheters was associated with a significant reduction in infectious c omplications. (C) 1998 Elsevier Science Inc.