Research Article

Prevention of hemodialysis catheter-related blood stream infections using a cotrimoxazole-lock technique

Azadeh Moghaddas

Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

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Mohammad-Reza Abbasi

Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran

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Afshin Gharekhani

Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran

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Simin Dashti-Khavidaki

*Author for correspondence:

E-mail Address: dashtis@sina.tums.ac.ir

Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran

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Effat Razeghi

Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran

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Atefeh Jafari

Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

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Hossein Khalili

Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

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Published Online:17 Feb 2015https://doi.org/10.2217/fmb.14.116

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Abstract

ABSTRACT

Background & aim: This trial assessed the efficacy of cotrimoxazole lock solution in reducing catheter-related blood stream infections (CRBSIs) among hemodialysis (HD) patients who were dialyzed using tunneled catheters. Method: Patients randomly received either heparin (2500 U/ml) (control group) or a mixture of 10 mg/ml cotrimoxazole (based on trimethoprim) and 2500 U/ml heparin (antibiotic group) as catheters lock solution. Results: Compared with the control group, CRBSIs rates per 1000 catheter-days was significantly lower (0.58 vs 4.4 events; p = 0.002) and cumulative infection-free catheter survival was significantly higher (log rank statistic 5.88; p = 0.015) in the antibiotic group. There were no statistical differences regarding incidences of catheter removal (8.7% in the antibiotic group vs 22% in the control group; p = 0.116) or thrombosis (2.2% in the antibiotic group vs 9.8% in the control group; p = 0.129) between the two groups. Conclusion: cotrimoxazole containing catheter lock solution is effective in reducing CRBSIs incidence and prolonging dialysis catheter survival in HD patients.

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

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History

Published online 17 February 2015

Published in print February 2015

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Acknowledgements

The authors would like to thank the nephrologists, nursing staff and patients of all HD wards involved in this study.

Financial & competing interests disclosure

This study was part of an Iranian BCPS thesis that has been supported by Tehran University of Medical Sciences (grant number 92-01-33-21582). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

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