CENTRAL VENOUS CATHETERS COATED WITH MINOCYCLINE AND RIFAMPIN FOR THEPREVENTION OF CATHETER-RELATED COLONIZATION AND BLOOD-STREAM INFECTIONS - A RANDOMIZED, DOUBLE-BLIND TRIAL

Background: Central venous catheters are a principal source of nosocom ial bloodstream infections, which are difficult to control. Objective: To determine the efficacy of catheters coated with minocycline and ri fampin in preventing catheter-related colonization and bloodstream inf ections. Design: Multicenter, randomized clinical trial. Setting: Five university-based medical centers. Patients: 281 hospitalized patients who required 298 triple-lumen, polyurethane venous catheters. Interve ntion: 147 catheters were pretreated with tridodecylmethyl-ammonium ch loride and coated with minocycline and rifampin. Untreated, uncoated c atheters (n = 151) were used as controls. Measurements: Quantitative c atheter cultures, blood cultures, and molecular typing of organisms to determine catheter-related colonization and bloodstream infections. R esults: The group with coated catheters and the group with uncoated ca theters were similar with respect to age, sex, underlying diseases, de gree of immunosuppression, therapeutic interventions, and risk factors for catheter infections. Colonization occurred in 36 (26%) uncoated c atheters and 11 (8%) coated catheters (P < 0.001). Catheter-related bl oodstream infection developed in 7 patients (5%) with uncoated cathete rs and no patients with coated catheters (P < 0.01). Multivariate logi stic regression analysis showed that coating catheters with minocyclin e and rifampin was an independent protective factor against catheter-r elated colonization (P < 0.05). No adverse effects related to the coat ed catheters or antimicrobial resistance were seen. An estimate showed that the use of coated catheters could save costs. Conclusions: Centr al venous catheters coated with minocycline and rifampin can significa ntly reduce the risk for catheter-related colonization and bloodstream infections. The use of these catheters may save costs.