It is my understanding that antibiotic lock solutions can be used to prevent catheter infection and to treat catheter infection when used in conjunction with an antibiotic infusion. I recently received an order for vancomycin 100mg/39ml in sodium chloride solution, 2ml by intra-cannular route tid PRN (Dwell while line not in use) for up to 9 days. Is this a typical vancomycin flush order and is it given alone without saline or heparin. Also, does the vancomycin flush have to be aspirated out of the catheter before the next infusion? From the information I have reviewed it appears the antibiotic lock needs to stay in place at least 60 minutes to be effective- is that correct? Any information of this topic would be helpful. Thank you.
There are numerous antibiotics used for locking a CVAD, but most of them are combined with heparin and allowed to dwell inside the lumen. The dose of antibiotic is always a higher dose than what is given by regular infusion because the ABX dose in a regular infusion will not penetrate the biofilm and kill the organism(s). Length of dwell time depends on the chosen ABX and what the physician prescribed. It should not be flushed or locked with saline or heparin alone as this will flush the ABX out of the lumen. When it is time for the next infusion through the catheter, the ABX lock solution should be aspirated from the lumen and not flushed into the patient, according to the 2014 SHEA Compendium on CLABSI. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861