Effectiveness of different central venous catheters for catheter-related infections: a network meta-analysis.

Abstract

We 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.

• Authors: H Wang, T Huang, J Jing, J Jin, P Wang, M Yang, W Cui, Y Zheng, H Shen
• Journal: The Journal of hospital infection (J Hosp Infect) Vol. 76 Issue 1 Pg. 1-11 (Sep 2010) ISSN: 1532-2939 [Electronic] England
• PMID: 20638155 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
• Copyright: Crown Copyright 2010. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Infective Agents, Local

Topics

• Anti-Infective Agents, Local (pharmacology)
• Catheter-Related Infections (epidemiology, prevention & control)
• Catheters, Indwelling (adverse effects)
• Cross Infection (epidemiology, prevention & control)
• Humans
• Randomized Controlled Trials as Topic