Catheter-related bacteremia (CRB) is a major cause of morbidity and mortality among patients receiving hemodialysis. These catheter-related blood stream infections (CRBSI) often lead to hospitalization and can lead to other serious infections including osteomyelitis and endocarditis.
In a past blog I spoke about sodium citrate as an efficacious alternative to heparin as a catheter locking solution. A recent study presented at the American Society of Nephrology’s Kidney Week 2011 meeting addressed adding the antibiotic gentamicin to sodium citrate catheter locking solutions.
Prophylactic antibiotic locks have been proven to be a safe and effective way to prevent CRB. The ideal locking solution for a hemodialysis patient would prevent clotting in the catheter and be effective against a broad spectrum of microorganisms while not leading to resistance. One such combination discussed at Kidney Week 2011 was gentamicin 320 micrograms/milliliter in sodium citrate 4%. In the study using the combination, the overall CRBSI rate was significantly lowered and the time to first CRB event was significantly delayed. In addition, no increase in gentamicin resistance was observed.
Additional studies on this potentially ground-breaking combination are currently under way. Your dialysis center should consider the potential benefits and keep a close eye on the ongoing studies. A sterile compounding pharmacy with experience in dialysis products, such as JCB, can help you explore this interesting development.