Role of hydrochloric acid in the treatment of central venous catheter infections in children with cancer

Cancer
Draga BarbaricPeter J Shaw

Abstract

The use of central venous catheters (CVCs) in pediatric cancer patients is associated with substantial risk of producing sepsis. The treatment of catheter-related infections has generally consisted of antibiotic administration with or without catheter removal. The authors report the first published experience using intraluminal hydrochloric acid (HCl) instillation as an adjunct to systemic antimicrobials in the management of catheter-related infections in children with cancer. All episodes of intraluminal instillation of 2 M HCl in oncology patients at The Children's Hospital at Westmead between December 1994 and August 2000 were reviewed. Episodes of HCl use were identified from a prospectively maintained infection data base. Successful treatment was defined as no recurrence of infection and no need for CVC removal in the 100 days after HCl administration. Forty-two episodes of HCl instillation were evaluated that occurred in children in whom blood cultures remained positive despite 48 hours of appropriate, systemic antibiotics and formed the basis of this review. All patients had in situ a surgically placed, subcutaneously tunneled CVC. The combination of systemic antibiotic therapy and HCl instillation was successful in erad...Continue Reading

Citations

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