Dear group;
We have one teenage patient whose tunneled CVC has been repeatedly growing Enterobacter species. Unfortunately catheter removal is not an option for her as she does not have any other viable veins.
I would like to ask any of you if you have any protocol for antibiotic lock therapy you could share with me.
Thank you,
Toshi Holland NP
Vascular Access Coordinator
Children's Hospital & Research Center Oakland
We do use antibiotic therapy as well as ethanol lock therapy. If your catheter is silicone, either can be an option. I would be more than happy to share the ethanol lock policy with you. The antibiotic lock therapy is imbedded in other policies. Since there are multiple antibiotics that can be used for this process, this is harder to clearly outline in a policy except for generalities. You can email me off line if needed ([email protected])
Janine Pritchett, RN-BC, BSN, VA-BC
Clinical Educator - Vascular Access
Numerous antibiotics, single drug and combinations with and without heparin have been reported in the literature. Do you have a sensitivity report to know what ABX this organism is sensitive to? Dosage is usually a much higher concentration than regular infusions when trying to salvage a CVAD because it requires higher concentrations to penetrate the biofilm. Then you must consider length of time the solution can reside in the lumen. A literature search will produce lots of studies. Also this is discussed in the CDC guidelines with references listed. 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