Antibiotic lock solutions allow less systemic antibiotic exposure and less catheter malfunction without adversely affecting antimicrobial resistance patterns

Ali Mirza Onder, A. A. Billings, Jayanthi Chandar, Linda Nield, Denise Francoeur, Nancy Simon, Carolyn Abitbol, Gaston E Zilleruelo

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

There are current concerns that antibiotic lock solutions (ABL) can induce antimicrobial resistance in long-term hemodialysis patients. Retrospective chart review of 157 children on hemodialysis between January 1997 and June 2006 was performed. In ERA I, only systemic antibiotics were used. In ERA II, ABL were added to systemic antibiotics when needed. In ERA III, ABL were used for treatment of all cases of catheter-related bacteremia (CRB) and for CRB prophylaxis in high-risk patients. The study includes 111,325 catheter days. The CRB incidence was 3.9 CRB/1000 catheter days. There was significant decrease for the total systemic antibiotic exposure (P=0.0484) and the percentage of catheters lost to malfunction (P=0.001) in ERA III. Protocol ABL exposure was associated with a trend to increased tobramycin-gentamicin resistance for gram-positive CRBs (P=0.2586) but with improved tobramycin-gentamicin resistance for gram-negative (P=0.0949) and polymicrobial CRBs (P=0.1776) and improved vancomycin resistance for gram-positive CRBs (P=0.0985). This retrospective analysis does not support the premise that ABL use will promote antimicrobial resistance in the hemodialysis population. The decreased exposure to systemic antibiotics by vigorous ABL use may even improve the antimicrobial resistance patterns in this population in the long term. Hemodialysis International

Original languageEnglish
Pages (from-to)75-85
Number of pages11
JournalHemodialysis International
Volume17
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Catheters
Anti-Bacterial Agents
Bacteremia
Renal Dialysis
Tobramycin
Gentamicins
Vancomycin Resistance
Population
Incidence

Keywords

  • Antibiotic locks
  • Antimicrobial resistance
  • Catheter-related bacteremia
  • Children
  • Dialysis
  • Sepsis

ASJC Scopus subject areas

  • Hematology
  • Nephrology

Cite this

Antibiotic lock solutions allow less systemic antibiotic exposure and less catheter malfunction without adversely affecting antimicrobial resistance patterns. / Onder, Ali Mirza; Billings, A. A.; Chandar, Jayanthi; Nield, Linda; Francoeur, Denise; Simon, Nancy; Abitbol, Carolyn; Zilleruelo, Gaston E.

In: Hemodialysis International, Vol. 17, No. 1, 01.01.2013, p. 75-85.

Research output: Contribution to journalArticle

Onder, Ali Mirza ; Billings, A. A. ; Chandar, Jayanthi ; Nield, Linda ; Francoeur, Denise ; Simon, Nancy ; Abitbol, Carolyn ; Zilleruelo, Gaston E. / Antibiotic lock solutions allow less systemic antibiotic exposure and less catheter malfunction without adversely affecting antimicrobial resistance patterns. In: Hemodialysis International. 2013 ; Vol. 17, No. 1. pp. 75-85.
@article{331f19357a654041998e9d14a18ace1a,
title = "Antibiotic lock solutions allow less systemic antibiotic exposure and less catheter malfunction without adversely affecting antimicrobial resistance patterns",
abstract = "There are current concerns that antibiotic lock solutions (ABL) can induce antimicrobial resistance in long-term hemodialysis patients. Retrospective chart review of 157 children on hemodialysis between January 1997 and June 2006 was performed. In ERA I, only systemic antibiotics were used. In ERA II, ABL were added to systemic antibiotics when needed. In ERA III, ABL were used for treatment of all cases of catheter-related bacteremia (CRB) and for CRB prophylaxis in high-risk patients. The study includes 111,325 catheter days. The CRB incidence was 3.9 CRB/1000 catheter days. There was significant decrease for the total systemic antibiotic exposure (P=0.0484) and the percentage of catheters lost to malfunction (P=0.001) in ERA III. Protocol ABL exposure was associated with a trend to increased tobramycin-gentamicin resistance for gram-positive CRBs (P=0.2586) but with improved tobramycin-gentamicin resistance for gram-negative (P=0.0949) and polymicrobial CRBs (P=0.1776) and improved vancomycin resistance for gram-positive CRBs (P=0.0985). This retrospective analysis does not support the premise that ABL use will promote antimicrobial resistance in the hemodialysis population. The decreased exposure to systemic antibiotics by vigorous ABL use may even improve the antimicrobial resistance patterns in this population in the long term. Hemodialysis International",
keywords = "Antibiotic locks, Antimicrobial resistance, Catheter-related bacteremia, Children, Dialysis, Sepsis",
author = "Onder, {Ali Mirza} and Billings, {A. A.} and Jayanthi Chandar and Linda Nield and Denise Francoeur and Nancy Simon and Carolyn Abitbol and Zilleruelo, {Gaston E}",
year = "2013",
month = "1",
day = "1",
doi = "10.1111/j.1542-4758.2012.00717.x",
language = "English",
volume = "17",
pages = "75--85",
journal = "Hemodialysis International",
issn = "1492-7535",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Antibiotic lock solutions allow less systemic antibiotic exposure and less catheter malfunction without adversely affecting antimicrobial resistance patterns

AU - Onder, Ali Mirza

AU - Billings, A. A.

AU - Chandar, Jayanthi

AU - Nield, Linda

AU - Francoeur, Denise

AU - Simon, Nancy

AU - Abitbol, Carolyn

AU - Zilleruelo, Gaston E

PY - 2013/1/1

Y1 - 2013/1/1

N2 - There are current concerns that antibiotic lock solutions (ABL) can induce antimicrobial resistance in long-term hemodialysis patients. Retrospective chart review of 157 children on hemodialysis between January 1997 and June 2006 was performed. In ERA I, only systemic antibiotics were used. In ERA II, ABL were added to systemic antibiotics when needed. In ERA III, ABL were used for treatment of all cases of catheter-related bacteremia (CRB) and for CRB prophylaxis in high-risk patients. The study includes 111,325 catheter days. The CRB incidence was 3.9 CRB/1000 catheter days. There was significant decrease for the total systemic antibiotic exposure (P=0.0484) and the percentage of catheters lost to malfunction (P=0.001) in ERA III. Protocol ABL exposure was associated with a trend to increased tobramycin-gentamicin resistance for gram-positive CRBs (P=0.2586) but with improved tobramycin-gentamicin resistance for gram-negative (P=0.0949) and polymicrobial CRBs (P=0.1776) and improved vancomycin resistance for gram-positive CRBs (P=0.0985). This retrospective analysis does not support the premise that ABL use will promote antimicrobial resistance in the hemodialysis population. The decreased exposure to systemic antibiotics by vigorous ABL use may even improve the antimicrobial resistance patterns in this population in the long term. Hemodialysis International

AB - There are current concerns that antibiotic lock solutions (ABL) can induce antimicrobial resistance in long-term hemodialysis patients. Retrospective chart review of 157 children on hemodialysis between January 1997 and June 2006 was performed. In ERA I, only systemic antibiotics were used. In ERA II, ABL were added to systemic antibiotics when needed. In ERA III, ABL were used for treatment of all cases of catheter-related bacteremia (CRB) and for CRB prophylaxis in high-risk patients. The study includes 111,325 catheter days. The CRB incidence was 3.9 CRB/1000 catheter days. There was significant decrease for the total systemic antibiotic exposure (P=0.0484) and the percentage of catheters lost to malfunction (P=0.001) in ERA III. Protocol ABL exposure was associated with a trend to increased tobramycin-gentamicin resistance for gram-positive CRBs (P=0.2586) but with improved tobramycin-gentamicin resistance for gram-negative (P=0.0949) and polymicrobial CRBs (P=0.1776) and improved vancomycin resistance for gram-positive CRBs (P=0.0985). This retrospective analysis does not support the premise that ABL use will promote antimicrobial resistance in the hemodialysis population. The decreased exposure to systemic antibiotics by vigorous ABL use may even improve the antimicrobial resistance patterns in this population in the long term. Hemodialysis International

KW - Antibiotic locks

KW - Antimicrobial resistance

KW - Catheter-related bacteremia

KW - Children

KW - Dialysis

KW - Sepsis

UR - http://www.scopus.com/inward/record.url?scp=84872673527&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872673527&partnerID=8YFLogxK

U2 - 10.1111/j.1542-4758.2012.00717.x

DO - 10.1111/j.1542-4758.2012.00717.x

M3 - Article

C2 - 22716190

AN - SCOPUS:84872673527

VL - 17

SP - 75

EP - 85

JO - Hemodialysis International

JF - Hemodialysis International

SN - 1492-7535

IS - 1

ER -