Vokurka, S., Kabatova-Maxova, K., Skardova, J., & Bystricka, E. (2009). Antimicrobial chlorhexidine/silver sulfadiazine-coated central venous catheters versus those uncoated in patients undergoing allogeneic stem cell transplantation. Supportive Care in Cancer, 17, 145–151.
To determine if using antimicrobial-coated central venous catheters (CVCs) is of benefit for patients undergoing stem cell transplantation
Patients were given multilumen polyurethane nontunneled antimicrobial chlorhexidine/silver sulfadiazine-coated CVCs. Transparent occlusive dressings were changed weekly or more frequently as needed. Blood cultures were taken from CVC lumens and peripheral blood on first occurrence of fever or at the discretion of medical staff. Skin swabs were taken from around the CVC insertion site with dressing changes before local disinfection. Povidone-iodine was used for skin disinfection with dressing changes and before CVC insertion. CVC insertion was stated to be under strict aseptic technique. Patient outcomes were compared to those of historical controls in whom noncoated CVCs were used.
Patients experienced fewer days with fever per 1,000 catheter days with the antimicrobial CVC (p < .001). No significant differences were observed between groups in insertion site inflammation or infection. Significantly fewer patients in the coated CVC group had positive blood cultures (45% versus 36%, p < .05) and peripheral positive blood cultures (p = .005).
This study provides minimal support that antimicrobial-coated CVCs may be of benefit for patients undergoing stem cell transplantation.
Results do not provide strong supportive evidence for use of chlorhexidine/silver sulfadiazine-coated CVCs because of study limitations.