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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Article Info
Publication History
Published online: December 05, 2005
Ann Arbor, MichiganFootnotes
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.).
Identification
Copyright
© 2005 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
