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Linezolid versus Vancomycin Antibiotic Lock Solution for the Prevention of Nontunneled Catheter‐related Blood Stream Infections in Hemodialysis Patients: A Prospective Randomized Study
Author(s) -
Sofroniadou Sofia,
Revela Ioanna,
Smirloglou Despina,
Makriniotou Ioanna,
Zerbala Sinodi,
Kouloubinis Alexandros,
Samonis George,
Iatrou Christos
Publication year - 2011
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2011.00965.x
Subject(s) - medicine , linezolid , vancomycin , catheter , hemodialysis , surgery , anesthesia , heparin , clinical endpoint , randomized controlled trial , staphylococcus aureus , biology , bacteria , genetics
The use of antibiotic lock solutions (ALSs) for the prevention of catheter‐related blood stream infections (CRBSIs) is a promising option. The efficacy and safety of linezolid as ALS were evaluated in a randomized double‐blind prospective study where 131 patients who required nontunneled catheter (NTC) for hemodialysis (HD) were randomized to receive an ALS with either (A) unfractionated heparin (2000 U/ml) alone as a catheter lock control, (B) vancomycin (5 mg/ml) + heparin (2000 U/ml), or (C) linezolid (2 mg/ml) + heparin (2000 U/ml). The primary endpoint of the study was CRBSI. A total of 152 NTCs were inserted in 131 patients. The linezolid‐locked group did not present any infective episode (CRBSI rate = 0/1000 catheter days) compared with 2 episodes in the vancomycin‐locked group (CRBSI rate = 1.21/1000 catheter days, p = 0.1021) and 11 episodes in the heparin‐locked group (CRBSI rate = 6.7/1000 catheter days, p = 0.0001). Median number of catheter days was greater in group C (median = 38) compared with group B (median = 36, p = 0.0415) and with group A (median = 34, p = 0.0036). No side effects and no resistant organisms were recorded with the use of linezolid ALS. Linezolid appears to be a safe and effective ALS, preventing CRBSI and prolonging the survival of the catheter in HD patients.