Prophylactic administration of doxycycline reduces central venous catheter infections in patients undergoing hematopoietic cell transplantation

Abstract

Hematopoietic stem cells are generally transfused through a central venous catheter (CVC), which also facilitates administration of medications and intravenous fluids. We had observed a high rate of CVC infections at our Bone Marrow Transplantation (BMT) unit. Accordingly, we evaluated the impact of administration of doxycycline as a prophylactic strategy to reduce CVC infection rates. Data was collected retrospectively on 54 consecutive patients, 26 who received doxycycline (doxycycline group), and we compared their outcomes to a previous cohort of 28 subjects who did not receive doxycycline (comparison group). The groups were comparable in regards to age, gender, transplant type, and CD34 cell dose. No (0%) CVC infection was observed in the doxycycline group, while 5 infection episodes (18%) occurred in 4 patients in the comparison group (p<0.001). Isolated organisms included: Escherichia-coli (EC)=1, coagulase-negative Staphylococcus-spp (CNSS)=2, both EC & CNSS=1. Notwithstanding the non-randomized comparative nature of our study, results suggest that CVC infection rate was reduced significantly after adding doxycycline for prophylaxis. A randomized controlled study is warranted to confirm these findings.