American Journal of Infectious Diseases

Antimicrobial-Impregnated Discs for Prevention of Intravenous Catheter-Related Infections

Kelly R. Daniels and Christopher R. Frei

DOI : 10.3844/ajidsp.2012.50.59

American Journal of Infectious Diseases

Volume 8, Issue 1

Pages 50-59

Abstract

Problem statement: Healthcare-associated infections are the 5th leading cause of death in the United States. Catheter-Related Bloodstream Infections (CRBSIs) comprise 14% of all healthcare-associated infections and contribute to increased mortality and financial costs. Antimicrobial-impregnated sponge discs to be used surrounding the catheter insertion site are a newer addition to the options available for the prevention of catheter-related infections. Approach: This review critically appraises the literature regarding the utility of antimicrobial-impregnated discs. We performed a literature search using the MEDLINE (1948-November 2011) database. Only controlled clinical trials were included and the electronic database search was performed using the following MeSH and keyword search terms: (“Biopatch” or “chlorhexidine”) and (“dressing” or “sponge”) and (“catheter”). Results: Our search yielded eight trials. Chlorhexidine-impregnated discs are effective in preventing catheter colonization in hospitalized patients and outpatients; however, effectiveness in preventing CRBSIs may be limited to hospitalized, critically ill patients. Although many studies have evaluated the effectiveness of several pharmaceutical agents for the prevention of catheter-related infections, there are still significant gaps in the literature regarding these infections, including the effectiveness of Polyhexamethylene Biguanide (PHMB)-impregnated discs and the cost-effectiveness of PHMB-impregnated discs compared to chlorhexidine-impregnated discs. It is also unclear if antimicrobial-impregnated discs are effective in specific populations, like in outpatients, patients at high risk compared to low risk patients and patients with long-term catheters. Conclusion: Chlorhexidine-impregnated discs should be utilized for the duration of catheterization in high risk, critically ill patients and in hospitals where catheter-related infection rates are persistently high despite other preventative strategies. Futher investigation of the effectiveness of these discs in other populations and of other antimicrobial-impregnated discs is needed.

Copyright

© 2012 Kelly R. Daniels and Christopher R. Frei. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.