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Table 7 Trials of haemodialysis catheter-locking solutions or catheter materials for CRBSI prevention

From: Catheter-related bloodstream infection in end-stage kidney disease: a Canadian narrative review

Interventiona Population size and characteristics Significant infection reduction? Limitations and attributes Ref
Cloxacillin vs. heparin 100 (uncuffed temporary lines) Yes (0.5 vs. 7.8/1000 catheter-days) Small sample, short median catheter life (60 days) [61]
Bismuth-coated catheters 77 (uncuffed catheters) No (significantly reduced catheter colonization in CFU/mL, 63 vs. 3.5, p < 0.001) Majority of catheters removed as HD no longer required [62]
Cefotaxime vs. heparin 113, >65 yrs. (tunnelled cuffed catheters) Yes (at 1 year, 68.7 vs. 31.3 %, p < 0.001) Small sample, high baseline proportion infection [63]
Cefotaxime vs. heparin 109, diabetic (tunnelled cuffed catheters) Yes (at 1 year, 3.7 vs. 1.6/1000 catheter-days) Small sample, majority of reduction attributable to Gram negative infections [64]
46.7 % citrate vs. heparinb 210 (tunnelled cuffed catheters) Yes (0.81 vs. 2.13/1000 catheter-days; p < 0.0001)
Thrombosis reduced (RR 0.87, 95 %CI 0.83–0.93, p < 0.0001)
Thrombosis measured indirectly (alteplase use), no benefit in diabetics or in those with prevalent catheters [65]
rtPA (1 of 3 sessions/week) vs. heparin (3 times/week) 225 (new HD lines) Yes (0.40 vs. 1.37/1000 catheter-days; p = 0.02)
Line failure reduced (20.0 vs. 34.8 %, p = 0.02)
RCT, patients and assessors blinded, high cost of rtPA [66]
Taurolidine-citrate-heparin vs. heparin 565 (tunnelled cuffed catheters) Yes (0.69 vs. 1.59/1000 catheter-days, p < 0.004) Single centre, 2-year prospective observational study (not randomized) [67]
  1. CFU colony-forming unit, mL millilitre, RCT randomized controlled trial, rtPA recombinant tissue plasminogen activator
  2. aAll antibiotic lock studies compared drug and heparin to heparin alone
  3. bEntire centre allocated to intervention for study period and compared to a control period. All studies prospective and randomized with 6-month follow-up unless otherwise indicated