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Ethanol lock therapy: preliminary trial results and future research agenda

Abstract number: 1733_101

Broom J.

Objectives:Pilot study: Primary aim: To evaluate the safety and efficacy of ethanol lock therapy (in conjunction with intravenous antibiotic therapy) in the treatment of infected tunneled central venous catheters. Prophylaxis study: Develop a clinical trial protocol to assess the efficacy of 70% ethanol lock therapy in prevention of tunneled central venous catheter-associated blood stream infections.

Methods:Pilot study: A prospective non-randomised trial of 70% ethanol locks to treat tunneled central venous catheter-associated blood stream infections was performed in nineteen patients.

Proposed prophylaxis study: We have designed a prospective, randomised, controlled trial of the weekly instillation of a 70% ethanol lock vs sterile heparin saline lock in patients requiring long-term haemodialysis via a tunneled central venous catheterm, to assess the efficacy of ethanol in preventing development of catheter-associted blood stream infections. 56 patients will be recruited to each arm.

Pilot study: These patients had a broad range of pathogens isolated. 12/17 patients completing ethanol lock therapy retained their catheter for greater than 14 days after the initiation of ethanol lock therapy (70% cure rate). 5/17 patients did not retain their catheter for 14 days, but 3 of these patients had their central venous catheter removed for reasons not attributable to recurrence of infection.

Proposed prophylaxis study: Results from the prophylactic study outlined above will demonstrate whether ethanol lock therapy is a safe and effective prophylactic intervention in patients requiring long-term haemodialysis.

Conclusions: Ethanol lock therapy seems effective in treatment of infected central venous catheters but it remains to be demonstrated to be effective in prophylaxis. Patients requiring long-term central venous catheterisation are a diverse group with a broad range of medical conditions. Further larger studies need to be designed to tease out the benefits of ethanol lock therapy these diverse specialty areas.

Results from this proposed prophylaxis trial will determine whether larger studies in more diverse patient groups are warranted to assess ethanol lock therapy.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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