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Antibiotic Lock??

Just wondering if anyone out there has an actual protocol and/or general recommendations on what to do with a line that is found without an injection cap on the end. (i.e. It has been sitting open to air for who knows how long?) A nurse called us with this exact thing and asked us to come assess the line. Do we recommend an antibiotic lock or should this line be pulled? Also, what about when a line is broken but repairable? Do you repair it and then proceed with a lock as it did have a hole in it prior to repair and could have potentially been exposed to an infection? Hope this makes sense and thanks for any input you may have.

The most recent information
The most recent information I have seen on antibiotic locks recommend their use only when you have a confirmed catheter infection. Catheter damage increases the risk of contamination but you do not have a confirmed infection yet. Research is not available yet to support use in these situations, I don't think, Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Along these same lines, I
Along these same lines, I had a PICC that was found to be without the dressing (no one apparently knows how long) and the catheter had migrated out such that it could not be used at it's current location.  Didn't know whether to "over the wire" replace (open-ended catheter) or just start fresh.  Thoughts anyone?
Robbin George
Depends--I have done
Depends--I have done both--New site if you have that option is preferable--BUT--If the current site is the ONLY viable location to have a PICC for this patient and they are negative for S/S of an infectious process related to the PICC then exchange  

Robbin George RN VA-BC

Kelly Smith
Our practice as far as an

Our practice as far as an "over the wire" exchange is that this is only a possiblity if the current site is absolutely healthy in appearance and there is no known history of possible contamination to the site.  Otherwise, it's a fresh start.  Also, as far as repairs, we are pretty picky about only repairing lines where the leakage site has been immediately cleansed and dressed with a sterile dressing, unless the likelihood of success for a new placement is low enough that it justifies the potential risk of infection.  Never have used an antibiotic lock.

Kelly Smith

PICC Nurse

Boone Hospital Center

Columbia, Missouri

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