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Use of Antimicrobial Catheter Lock Solutions to Prevent Catheter-Related Bacteremia

Section on Nephrology, Wake Forest University School of Medicine, Winston Salem, North Carolina

Address correspondence to: Dr. Anthony J. Bleyer, Section on Nephrology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157. Phone: 336-716-4513; Fax: 336-716-4318; E-mail: ableyer{at}wfubmc.edu

Catheter-related bacteremia is an important source of morbidity and mortality in hemodialysis patients. A number of well-designed, controlled, prospective trials using antimicrobial catheter lock solutions to prevent catheter-related bacteremia have shown a dramatic, statistically significant decrease in not only infection but also mortality related to catheter-related bacteremia. Despite evidence of significant benefit, these locks are not routinely used in the United States. This review describes the epidemic problem of catheter-related bacteremia, reviews recent clinical trials with antimicrobial catheter lock solutions, and discusses current options and potential indications for catheter lock solutions in the hemodialysis population.

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