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Long-Term Silicone Central Venous Catheters Impregnated With Minocycline and Rifampin Decrease Rates of Catheter-Related Bloodstream Infection in Cancer Patients: A Prospective Randomized Clinical Trial

From the Departments of Infectious Diseases, Infection Control and Employee Health, Sarcoma Medical Oncology, Infusion Therapy Surgical Oncology, Biostatistics, and Leukemia, Division of Infectious Diseases, The University of Texas M.D. Anderson Cancer Center and Veterans Affairs Medical Center, Houston, TX

Address reprint requests to Hend A. Hanna, MD, MPH, The University of Texas M.D. Anderson Cancer Center, Department of Infectious Diseases, Infection Control, and Employee Health (Unit 402), 1515 Holcombe Blvd, Houston, TX 77030; e-mail: hhanna{at}mdanderson.org

PURPOSE: To evaluate the efficacy of long-term nontunneled silicone catheters impregnated with minocycline and rifampin (M-R) in reducing catheter-related bloodstream infections.

PATIENTS AND METHODS: This prospective, randomized, double-blind clinical trial was conducted at M.D. Anderson Cancer Center, a tertiary care hospital in Houston, TX. All patients in the trial had a malignancy.

RESULTS: Between September 1999 and May 2002, 356 assessable catheters were used: 182 M-R and 174 nonimpregnated. The patients' characteristics were comparable between the two study groups. The mean (± standard deviation) duration of catheterization with M-R catheters was comparable to that of nonimpregnated catheters (66.21 ± 30.88 v 63.01 ± 30.80 days). A total of 17 catheter-related bloodstream infections occurred during the course of the study. Three were associated with the use of M-R catheters and 14 were associated with the nonimpregnated catheters, with a rate of catheter-related bloodstream infection of 0.25 and 1.28/1,000 catheter-days, respectively (P = .003). Gram-positive cocci accounted for the majority of the organisms causing the infections. There were no allergic reactions associated with M-R catheters.

CONCLUSION: Long-term nontunneled central venous catheters impregnated with minocycline and rifampin are efficacious and safe in reducing catheter-related bloodstream infections in cancer patients.

Supported in part by grant CS99-2221rm from Cook Critical Care.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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