Antibiotic locks for the treatment of catheter-related blood stream infection: Still more hope than data.
Journal
Seminars in dialysis
ISSN: 1525-139X
Titre abrégé: Semin Dial
Pays: United States
ID NLM: 8911629
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
pubmed:
6
4
2019
medline:
28
4
2020
entrez:
6
4
2019
Statut:
ppublish
Résumé
Antibiotic lock therapy (ALT), in conjunction with systemic antibiotics, is recommended by scientific societies as a treatment of uncomplicated catheter-related bloodstream infections (CRBSI) in hemodynamically stable hemodialysis patients for whom catheter salvage is the goal. The rationale for this strategy is the eradication of intraluminal biofilms by the highly concentrated antibiotic used in the lock. However, the available evidence supporting this recommendation is scanty, and only includes small, short-term, observational studies (most of them single-arm), with different definitions of CRBSI cure and variable follow-up periods. Furthermore, the ability of an antibiotic to eradicate a biofilm is not predicted by its inherent spectrum of antibacterial activity, since sessile microorganisms in their biofilm display other mechanisms of resistance to antibiotics than their planktonic counter-parts. Additionally, penetration of some antibiotics frequently used into biofilms produced by common microorganisms appears to be low. In this editorial we provide a critical view on the available evidence regarding the efficacy of ALT on the treatment of CRBSI in hemodialysis patients, as well as the microbiological issues and technical challenges of this strategy.
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Editorial
Langues
eng
Sous-ensembles de citation
IM
Pagination
402-405Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
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