Efficacy of Antiseptic-Impregnated Central Venous Catheters

Abstract

ContextCentral venous catheters impregnated with chlorhexidine and silver sulfadiazine have recently been introduced for the prevention of catheter-related infections. However, there remains some uncertainty regarding the efficacy of these catheters because of conflicting reports in the literature.ObjectiveTo evaluate the efficacy of chlorhexidine–silver sulfadiazine–impregnated central venous catheters in the prevention of catheter-related bloodstream infection.Data SourcesStudies identified from a computerized search of the MEDLINE database from January 1966 to January 1998, reference lists of identified articles, and queries of principal investigators and the catheter manufacturer.Study SelectionRandomized trials comparing chlorhexidine–silver sulfadiazine–impregnated central venous catheters with nonimpregnated catheters were included. The outcomes assessed were catheter colonization and catheter-related bloodstream infection confirmed by catheter culture.Data ExtractionTwelve studies met the inclusion criteria for catheter colonization and included a total of 2611 catheters. Eleven studies with a total of 2603 catheters met the inclusion criteria for catheter-related bloodstream infection. Most patients in these studies were from groups considered to be at high risk for catheter-related infections. Summary statistics were calculated using Mantel-Haenszel methods under a fixed-effects model.Data SynthesisThe summary odds ratio for catheter colonization was 0.44 (95% confidence interval [CI], 0.36-0.54; P