PMID: 18413621Apr 17, 2008Paper

Meta-analysis: antibiotics for prophylaxis against hemodialysis catheter-related infections

Annals of Internal Medicine
Matthew T JamesAlberta Kidney Disease Network

Abstract

Catheter-related infections cause morbidity and mortality in patients undergoing hemodialysis. To examine whether topical or intraluminal antibiotics reduce catheter-related bloodstream infection compared with no antibiotic therapy in adults undergoing hemodialysis. Electronic databases, trial registries, bibliographies, and conference proceedings up to October 2007, with no language restrictions. Two reviewers independently selected randomized, controlled trials using topical or intraluminal antibiotics for prophylaxis of infection in adults with catheters who are undergoing hemodialysis. Two independent reviewers assessed studies for inclusion, quality, and extracted data. Fixed-effects models were used to estimate pooled rate ratios for outcomes. Topical antibiotics reduced the rate of bacteremia (rate ratio, 0.22 [95% CI, 0.12 to 0.40]; 0.10 vs. 0.45 case of bacteremia per 100 catheter-days), exit-site infection (rate ratio, 0.17 [CI, 0.08 to 0.38]; 0.06 vs. 0.41 case of infection per 100 catheter-days), need for catheter removal, and hospitalization for infection. Intraluminal antibiotics reduced the rate of bacteremia (rate ratio, 0.32 [CI, 0.22 to 0.47]; 0.12 vs. 0.32 case of bacteremia per 100 catheter-days) and need fo...Continue Reading

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