The impact of ethanol lock therapy on length of stay and catheter salvage in pediatric catheter-associated bloodstream infection

Background. Ethanol lock therapy (ELT) with systemic antimicrobial therapy (SAT) is a treatment for catheterassociated bloodstream infections (CABSI). However, its impact on hospital length of stay (LOS) is unknown. Objectives. Assess the impact of ELT on LOS, LOS attributable to CABSI (ALOS), and catheter salvage in pediatric hematology, oncology, stem cell transplant (HOSCT) CABSI. Methods. Retrospective review of HOSCT CABSI from January 2009 to July 2011. Results. A total of 124 CABSI episodes were reviewed in 66 patients. Mean LOS with ELT after 1 positive blood culture (BC) was 7.1 versus 12.3 days after ≥2 positive BC (P = .014). Mean ALOS was 1.6 days with ELT versus 2.9 days without ELT (P = .018). Mean ALOS with ELT after 1 positive BC was 3.75 days versus 5.8 days after ≥2 positive BC (P = .022). Catheter salvage rate: 41 of 48 (85%) with ELT versus 49 of 68 (72%) without ELT (P = .169). Conclusion. Earlier initiation of ELT may decrease ALOS.