Article ID Journal Published Year Pages File Type
3372513 Journal of Hospital Infection 2010 11 Pages PDF
Abstract

SummaryWe aimed to compare the effectiveness of various catheters for prevention of catheter-related infection and to evaluate whether specific catheters are superior to others for reducing catheter-related infections. We identified randomised, controlled trials that compared different types of central venous catheter (CVC), evaluating catheter-related infections in a systematic search of articles published from January 1996 to November 2009 via Medline, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. Network meta-analysis with a mixed treatment comparison method using Bayesian Markov Chain Monte Carlo simulation was used to combine direct within-trial, between-treatment comparisons with indirect trial evidence. Forty-eight clinical trials (12 828 CVCs) investigating 10 intervention catheters contributed to the analyses. For prevention of CVC colonisation, adjusted silver iontophoretic catheters (odds ratio: 0.58; 95% confidence interval: 0.33–0.95), chlorhexidine and silver sulfadiazine catheters (0.49; 0.36–0.64), chlorhexidine and silver sulfadiazine blue plus catheters (0.37; 0.17–0.69), minocycline–rifampicin catheters (0.28; 0.17–0.43) and miconazole–rifampicin catheters (0.11; 0.02–0.33) were associated with a significantly lower rate of catheter colonisation compared with standard catheters. For prevention of CRBSI, adjusted heparin-bonded catheters (0.20; 0.06–0.44) and minocycline–rifampicin catheters (0.18; 0.08–0.34) were associated with a significantly lower rate of CRBSI with standard catheters. Rifampicin-based impregnated catheters seem to be better for prevention of catheter-related infection compared with the other catheters.

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