Short-dwell ethanol lock therapy in children is associated with increased clearance of central line-associated bloodstream infections

Clin Pediatr (Phila). 2011 Oct;50(10):943-51. doi: 10.1177/0009922811409568. Epub 2011 May 27.

Abstract

Background: Central line-associated bloodstream infection (CLABSI) is a known complication of central line use. Salvage of infected central lines with ethanol lock therapy (ELT) with systemic antimicrobials may be an alternative treatment option in children.

Methods: Retrospective review was performed in children with CLASBI who underwent short-dwell ELT (70% ethanol, 4- to 25-hour dwell times ≤3 days) with systemic antimicrobials from January 1, 2007 to July 15, 2009.

Results: A total of 59 patients, aged 2 months to 19 years (mean ± SD = 6.3 ± 6.1 years) with 80 episodes of CLABSI were included. The CLABSI eradication rate was 86% (69/80 episodes; 95% confidence interval [CI] 78%, 94%), significantly greater than 50% (Z = 2.35, P < .05), the estimated clearance rate of CLABSI eradication using systemic antimicrobials alone. Overall central line retention was 78% (60/77 episodes, 95% CI 69%, 87%). ELT was well tolerated.

Conclusions: These findings suggest the potential benefit of short-dwell ELT combined with systemic antimicrobials in CLABSI treatment. Randomized controlled trials are needed.

MeSH terms

  • Adolescent
  • Anti-Infective Agents / administration & dosage
  • Bacteremia / drug therapy
  • Bacteremia / prevention & control*
  • Catheter-Related Infections / prevention & control*
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation
  • Catheters, Indwelling / adverse effects*
  • Child
  • Child, Preschool
  • Cross Infection / prevention & control*
  • Equipment Contamination / prevention & control
  • Ethanol / administration & dosage*
  • Female
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents
  • Ethanol