AJIC: American Journal of Infection Control
Volume 34, Issue 6 , Pages 388-393, August 2006

Are antiseptic-coated central venous catheters effective in a real-world setting?

  • Debaroti M. Borschel, MD, MS

      Affiliations

    • From the Department of Internal Medicine, University of Michigan
    • Patient Safety Enhancement Program, Ann Arbor VA Medical Center and the University of Michigan Health System
    • Corresponding Author InformationReprint requests: Debaroti M. Borschel, MD, 3116 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0376.
  • ,
  • Carol E. Chenoweth, MD

      Affiliations

    • From the Department of Internal Medicine, University of Michigan
    • Department of Infection Control and Epidemiology, University of Michigan
  • ,
  • Samuel R. Kaufman, MA

      Affiliations

    • Patient Safety Enhancement Program, Ann Arbor VA Medical Center and the University of Michigan Health System
  • ,
  • Kristi Vander Hyde, MS, APRN, CIC

      Affiliations

    • Department of Infection Control and Epidemiology, University of Michigan
  • ,
  • Kristen A. VanDerElzen, MPH, CIC

      Affiliations

    • Department of Infection Control and Epidemiology, University of Michigan
  • ,
  • Trivellore E. Raghunathan, PhD

      Affiliations

    • Department of Biostatistics, University of Michigan
  • ,
  • Curtis D. Collins, PharmD, MS

      Affiliations

    • Department of Pharmacy Services, University of Michigan Health System
  • ,
  • Sanjay Saint, MD, MPH

      Affiliations

    • Ann Arbor VA Health Services Research and Development Center of Excellence, Ann Arbor, MI
    • From the Department of Internal Medicine, University of Michigan
    • Patient Safety Enhancement Program, Ann Arbor VA Medical Center and the University of Michigan Health System

published online 05 December 2005.

Ann Arbor, Michigan

Background

Catheter-related bloodstream infections are common, costly, and morbid. Randomized controlled trials indicate that antiseptic-coated central venous catheters reduce infection rates.

Objective

To assess the clinical and economic effectiveness of antiseptic-coated catheters for critically ill patients in a real-world setting.

Methods

Central venous catheters coated with chlorhexidine/silver-sulfadiazene were introduced in all patients requiring central venous access in adult intensive care units at the University of Michigan Health System, a large, tertiary care teaching hospital. A pretest-posttest cohort design measured the primary outcome of catheter-related bloodstream infection rate, comparing the 2 years prior to the intervention with the 2 years following the intervention. We also evaluated cost-effectiveness and changes in vancomycin use.

Results

The intervention was associated with a 4% per month relative reduction in the incidence of catheter-related bloodstream infection, after controlling for the effects of time. Overall, a 35% relative risk reduction (P < .0003) in the catheter-related bloodstream infection rate occurred in the posttest phase. The use of antiseptic-coated catheters reduced costs more than $100,000 annually. Vancomycin use was less in units in which antiseptic catheters were used compared with wards in which these catheters were not used.

Conclusion

Antiseptic-coated catheters appear to be clinically effective and economically efficient in a real-world setting.

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 Supported, in part, by a Patient Safety Fellowship award provided by C. R. Bard and the Research Foundation for the Prevention of Complications Associated with Health Care and the VA/UM Patient Safety Enhancement Program and by a Career Development Award from the Health Services Research & Development Program of the Department of Veterans Affairs and a Patient Safety Developmental Center Grant from the Agency for Healthcare Research and Quality (P20-HS11540, to S.S.).

PII: S0196-6553(05)00775-3

doi:10.1016/j.ajic.2005.08.004

AJIC: American Journal of Infection Control
Volume 34, Issue 6 , Pages 388-393, August 2006