Efficacy of sodium citrate antimicrobial locks for reducing rates of catheter-related bacteremia.

摘要

Power et al1 conclude that the use of 46.7% trisodium citrate as an antimicrobial lock solution is not warranted despite efficacious and safe use elsewhere, including our center.2 They observed no improvement in catheter-related bacteremia (CRB), with rates of 0.7 episode/1,000 at-risk patient-days in both the treatment and (heparin) control arms. A recent systematic review3 of antimicrobials in the prevention of CRB reviewed 18 trials of antimicrobial locks in which heparin locks were the control arm. When data were available in trials of tunneled catheters alone, the median CRB rate was 3.12 episodes/1,000 days, or calculated differently, in a total of 102,447 patient at-risk days in 12 trials, 288 bacteremias accounted for a rate of 2.81 episodes/1,000 days.