Use of antibiotic locks to treat colonized central venous catheters

Infections that result from bacterial colonization of central venous cathet ers are a significant problem in modern healthcare. The most effective mean s of eradication of such infections is the removal of colonized lines, but line removal carries drawbacks of its own and in many cases the balance of risks favours treatment in situ. Systemic antibiotics are usually administe red but these frequently fall to achieve sterilization, and accordingly att ention has turned to intraluminal therapy using antibiotic locks, in which 1-2 mL of a concentrated antibiotic solution is instilled to fill the lumen , left for a predetermined period, and removed. The evidence in favour of t his technique is anecdotal and should not be allowed to influence any decis ion about line removal, but is sufficiently encouraging to justify the use of locks when in situ treatment is deemed acceptable. Indications, agents a nd appropriate administration regimes are discussed.