Antibiotic catheter lock: An adjunct therapy for recurrent tunneled hemodialysis catheter infections

Abstract

The objective of the study is to evaluate the use of antibiotic catheter locks in reducing recurrent catheter-related bloodstream infections (CRBSIs) in hemodialysis (HD) patients. This prospective case series was conducted at ASeeb Renal Dialysis Center, from September 2022 to August 2023, including four hemodialysis outpatients with recurrent catheter-related infections. All patients were unfit for an arteriovenous fistula (AVF) or graft (AVG) and were maintained on dialysis via their last access option, which was a tunneled hemodialysis catheter (internal jugular). These patients had a history of recurrent hospitalizations and readmissions. Prior to the intervention, these patients averaged seven hospital admissions per year, requiring five-day courses of intravenous antibiotics for each episode. During the study, patients started on an antibiotic catheter lock (Vancomycin or Gentamycin) tailored to their most recent blood culture results, which was continued for one year. Over the one-year follow-up period, there was a zero incidence of catheter-related infections, hospitalizations, and readmissions. Furthermore, a substantial decrease in the required erythropoietin dose was observed. The use of antibiotic catheter locks was highly effective in eradicating CRBSI in hemodialysis patients with recurrent infections. This approach led to a marked reduction in costs, both directly by preventing infections and subsequent hospitalizations and indirectly by decreasing the required erythropoietin doses.