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

Eric J. McGrath, Ralph Salloum, Xinguang Chen, Yifan Jiang, Kathrina Boldt-Macdonald, Cristie Becker, Roland Chu, Jocelyn Y. Ang

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

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.

Original languageEnglish
Pages (from-to)943-951
Number of pages9
JournalClinical Pediatrics
Volume50
Issue number10
DOIs
StatePublished - Oct 2011

Keywords

  • bloodstream infection
  • central line-associated bloodstream infection (CLABSI)
  • children
  • ethanol lock
  • intravascular device
  • pediatrics

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