Abstract
Background: Central venous catheters (CVCs) are essential for improving the quality of life of pediatric cancer patients during treatment. Catheter colonization is one of the most frequent complications, and CVC removal is a standard approach to treating catheter colonization. Some studies showed that antibiotic lock therapy (ALT) could rescue colonized CVCs, but the evidence supporting the efficacy of ALT is still unclear. Thus, here, we report our experience with ALT in the treatment of catheter colonization in pediatric cancer patients.
Methods: A retrospective chart review was performed for 113 pediatric cancer patients with CVCs (tunneled cuffed catheters) at the University of Tokyo Hospital from April 2008 to August 2013. This study involved 28942 total catheter days. There were 172 episodes of catheter colonization during this period, 15 of which were treated with ALT for about 7 days, mainly with vancomycin (n=13). ALT success was defined as negative blood culture after the ALT.
Results: ALT succeeded in 13 episodes (86.7%). The incidence of catheter colonization was 5.70 per 1000 CVC days in the ALT-rescued CVC group, whereas it was 5.95 per 1000 CVC days in the newly inserted CVC group. The cumulative incidence rate of catheter colonization and the duration of use were almost identical between the two groups (p=0.399 and 0.267, respectively). Two episodes were treated with ALT alone and required the removal of the catheters.
Conclusion: ALT with systemic antibiotics for the treatment of catheter colonization is effective in pediatric cancer patients.
