• Luca Filippi, Marco Pezzati, Simona Di Amario, Chiara Poggi, and Patrizia Pecile.
• Department of Critical Care Medicine, Meyer Children's Hospital, Florence, Italy. filippi.luca@virgilio.it
• Pediatr Crit Care Me. 2007 Nov 1; 8 (6): 556-62.

ObjectiveCatheter-related bloodstream infections (CRBSIs) are one of the main morbidities in critically ill neonates. The objective of the present study was to assess the efficacy of a fusidic acid-heparin lock in the prevention of CRBSIs.DesignA preliminary retrospective study showed that staphylococcal infections were largely prevalent. We planned a prospective, randomized trial to ascertain whether fusidic acid and heparin lock of central venous catheters would reduce the incidence of CRBSIs.SettingLevel III neonatal intensive care unit.PatientsOne hundred three neonates were enrolled and randomly assigned to a treatment group (n = 50) or control group (n = 53).InterventionsFusidic acid (4 mg/mL) and heparin (10 IU/mL) lock in the treatment group.Measurements And Main ResultsThe treatment group showed significantly lower incidence of CRBSIs (6.6 vs. 24.9 per 1000 catheter days; p < .01; relative risk 0.28; 95% confidence interval 0.13-0.60). No staphylococcal infections occurred in the treatment group, while in the control group Staphylococcus remained the main agent of CRBSI. Cost analysis comparing the present study and for the treatment of CRBSIs proved that antibiotic lock is financially favorable.ConclusionsFusidic acid-heparin lock solution reduced the incidence of CRBSIs in our neonatal intensive care unit. However, we recommend basing antibiotic lock on local CRBSI epidemiology. With regard to fusidic acid, further and broader studies could be useful to confirm our results.

37 keywords...

hide…