Antimicrobial Lock Therapy: A Strategy for Managing Catheter-Related Bacteremia

İngilizce (OpenAlex)

Objectives: This study aims to evaluate the use and efficacy of antibiotic-lock therapy (ALT) in the management of catheter-related bloodstream infections (CRBSIs), focusing on its impact on infection resolution, catheter retention, and clinical outcomes. Methods: Patients aged ≥18 years diagnosed with CRBSIs who had long-term indwelling catheters and for whom catheter replacement posed clinical challenges were enrolled in the retrospective study from January 2019 to December 2024. Participants were divided into two groups based on treatment: Group 1 received intravenous (IV) antibiotics combined with antibiotic-lock therapy (ALT), while Group 2 received IV antibiotics alone. Patient demographics, pathogen distribution, administered antibiotic regimens, duration of treatment, laboratory parameters, clinical outcomes, and mortality rates were evaluated. Results: A total of 54 patients were included, of whom 42.6% were female, and the mean age was 66.3 ± 15.4 years. Group 1 comprised 50% of the study population. The median treatment duration was 14 days. The most common pathogen was Coagulase-negative staphylococci, and 33.3% of CRBSIs were caused by Gram-negative bacteria (GNB). Group 1 demonstrated lower C-reactive protein levels at treatment 48/72 h of treatment (p = 0.013) and a reduced frequency of catheter revision (p < 0.0001) compared to Group 2. Overall, ALT achieved a success rate of 88.9%, with success rates of 86% for GNB infections and 90% for Gram-positive bacterial infections. Among patients receiving daily ALT, the success rate was 86%, while those receiving the therapy every three days had a success rate of 90%. Conclusions: Antimicrobial lock therapy can be considered a treatment option for managing CRBSIs, particularly in cases where removal of the implantable catheter is not feasible, allowing for salvage.