Health Problem: Central line-associated bloodstream infections (CLABSIs) have a high rate of mortality among hospital-acquired infections. These infections pose such a high risk because patients who require central venous catheters (CVCs) are usually acutely ill or highly immunosuppressed.
Technology Description: Antimicrobial CVCs (AMCVCs) are identical to uncoated CVCs, except that they are coated with antimicrobial agents such as minocycline and rifampicin (M-R); chlorhexidine and silver sulfadiazine; or a compound of silver, platinum, and carbon black.
Controversy: The use of AMCVCs has demonstrated a reduction in the risk of CLABSIs across multiple pooled analyses when compared with uncoated catheters; however, cost-effectiveness analyses modeling the savings from CLABSI reductions versus the cost increase for AMCVCs over uncoated CVCs found mixed results. The use of antibiotic-impregnated CVCs has also been considered to pose a potential risk for antimicrobial resistance, although evidence from a recent study did not find a change in antimicrobial resistance patterns after the adoption of M-R-coated CVCs in an intensive care unit during more than a 10-year period.
Key Questions:
Do AMCVCs reduce the occurrence of CLABSIs compared with usual (uncoated) CVCs?
How do AMCVCs compare with each other regarding reduction in CLABSIs?
Are there safety concerns related to AMCVCs?
Have definitive patient selection criteria for the use of AMCVCs been established?
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