Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Taurolidine-citrate-heparin lock reduces catheter-related bloodstream infections in intestinal failure patients dependent on home parenteral support: a randomized, placebo-controlled trial

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Body mass index trajectories in early childhood in relation to cardiometabolic risk profile and body composition at 5 years of age

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Investigating the effect of sex and ketosis on weight-loss-induced changes in appetite

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Is abdominal obesity at baseline influencing weight changes in observational studies and during weight loss interventions?

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. An international study of the quality of life of adult patients treated with home parenteral nutrition

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Hydrochloric acid prolongs the lifetime of central venous catheters in haematologic patients with bacteraemia

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Long-Term Outcomes of Partial Oral Treatment of Endocarditis

    Research output: Contribution to journalLetterResearch

  4. Epidemiology of bloodstream infections in patients with chronic lymphocytic leukemia: a longitudinal nation-wide cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Background: In patients with intestinal failure who are receiving home parenteral support (HPS), catheter-related bloodstream infections (CRBSIs) inflict health impairment and high costs.Objective: This study investigates the efficacy and safety of the antimicrobial catheter lock solution, taurolidine-citrate-heparin, compared with heparin 100 IE/mL on CRBSI occurrence.Design: Forty-one high-risk patients receiving HPS followed in a tertiary HPS unit were randomly assigned in a double-blinded, placebo-controlled trial. External, stratified randomization was performed according to age, sex, and prior CRBSI incidence. The prior CRBSI incidence in the study population was 2.4 episodes/1000 central venous catheter (CVC) days [95% Poisson confidence limits (CLs): 2.12, 2.71 episodes/1000 CVC days]. The maximum treatment period was 2 y or until occurrence of a CRBSI or right-censoring because of CVC removal. The exact permutation tests were used to calculate P values for the log-rank tests.Results: Twenty patients received the taurolidine-citrate-heparin lock and 21 received the heparin lock, with 9622 and 6956 treatment days, respectively. In the taurolidine-citrate-heparin arm, no CRBSIs occurred, whereas 7 CRBSIs occurred in the heparin arm, with an incidence of 1.0/1000 CVC days (95% Poisson CLs: 0.4, 2.07/1000 CVC days; P = 0.005). The CVC removal rates were 0.52/1000 CVC days (95% Poisson CLs: 0.17, 1.21/1000 CVC days) and 1.72/1000 CVC days (95% Poisson CLs: 0.89, 3.0/1000 CVC days) in the taurolidine-citrate-heparin and heparin arm, respectively, tending to prolong CVC survival in the taurolidine arm (P = 0.06). Costs per treatment year were lower in the taurolidine arm (€2348) than in the heparin arm (€6744) owing to fewer admission days related to treating CVC-related complications (P = 0.02).Conclusions: In patients with intestinal failure who are life dependent on HPS, the taurolidine-citrate-heparin catheter lock demonstrates a clinically substantial and cost-beneficial reduction of CRBSI occurrence in a high-risk population compared with heparin. This trial was registered at clinicaltrials.gov as NCT01948245.

Original languageEnglish
JournalThe American journal of clinical nutrition
Volume106
Issue number3
Pages (from-to)839-848
Number of pages10
ISSN0002-9165
DOIs
Publication statusPublished - Sep 2017

    Research areas

  • Adult, Aged, Bacteremia, Catheter-Related Infections, Central Venous Catheters, Citrates, Cost-Benefit Analysis, Female, Heparin, Humans, Incidence, Intestinal Diseases, Intestines, Male, Middle Aged, Parenteral Nutrition, Home, Taurine, Thiadiazines, Journal Article, Randomized Controlled Trial

ID: 52668339