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Kidney Week

Abstract: PO1352

Meta-Analysis of Antibiotic and Non-Antibiotic Lock Solutions for Prevention of Hemodialysis Catheter-Related Infections

Session Information

  • Vascular Access
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Abdul Salim, Sohail, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Soliman, Karim Magdy, Medical University of South Carolina, Charleston, South Carolina, United States
  • Tapolyai, Mihaly B., Hatvan Hemodialysis Units, Hatvan, Hungary
  • Zsom, Lajos, Cegléd Hemodialysis Units, Cegled, Hungary
  • Fulop, Tibor, Medical University of South Carolina, Charleston, South Carolina, United States
Background

Catheter-related bloodstream infection (CRBSI) associated with hemodialysis catheters are associated with increased mortality and morbidity whilst posing a significant financial burden on health care. The effects of antibiotic and antimicrobial locking solutions on the risk of CRBSI are unclear.

Methods

From inception to April 2020, we looked for relevant clinical controlled trials in the following databases: EBSCO, PubMed, Cochrane CENTRAL, MEDLINE, EMBASE, clinicaltrial.gov, Google Scholar and performed a meta-analysis of the identified studies.

Results

26 studies with 4,967 patients reported on the incidence of catheter-related bacteremia (CRBSI). The overall pooled Risk Ratio (RR) was lower in the intervention group signaling a 70% lower incidence of CRBSI compared with the heparin group (RR= 0.30, 95% CI [0.25, 0.36], p<0.001). Subgroup analysis showed that the administration of antibiotic regimens led to a 72% decrease in the risk of CRBSI episodes (RR=0.28, 95% CI [0.21, 0.37], p<0.0001), whereas non-antibiotic antimicrobial solutions reduced the risk of CRBSI by 68% (RR= 0.32, 95% CI [0.25, 0.41], p<0.0001). A test for subgroup differences revealed no significant difference favoring either of the two interventions.

Conclusion

Both antibiotic and antimicrobial solutions are effective in reducing CRBSI.