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Coated and Uncoated Central Venous Catheters: A Review of Comparative Clinical Effectiveness and Safety

Published on: January 15, 2019
Project Number: RC1057-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of coated versus non-coated central venous catheters to prevent infection in adult patients?
  2. What is the safety of coated central venous catheters in adult patients?

Key Message

Four systematic reviews with meta-analyses and three primary studies comparing coated central venous catheters and non-coated central venous catheters were identified by this review. The evidence compared various coatings such as chlorhexidine/silver sulfadiazine, silver, minocycline-rifampicin, and micozonazole-rifampicin; however, no evidence was identified describing polyHexaMethylene biguanide coated central venous catheters.The systematic reviews were generally characterized by a low risk of bias. Three of the systematic reviews reported a statistically significant lower risk of catheter-related bloodstream infection with antimicrobial and antibiotic coated central venous catheters compared to non-coated central venous catheters. The fourth systematic review reported the findings of a meta-analysis indicating there was no difference in catheter-related bloodstream infections for silver coated central venous catheters compared to non-coated central venous catheters. Adverse events were captured in two of the systematic reviews and both concluded there was no statistical difference between the antimicrobial and antibiotic coated central venous catheters compared with non-coated central venous catheters. Three non-randomized, comparative primary studies were identified from a single center in Spain reporting a statistically significant lower rate of catheter-related bloodstream infections with chlorhexidine/silver sulfadiazine coated catheters compared to non-coated central venous catheters for subclavian venous access, internal jugular venous access, and femoral venous access. Most of the studies included in this review point to a lower risk of catheter-related bloodstream infection with the use of antimicrobial or antibiotic coated central venous catheters compared to non-coated central venous catheters with no difference in adverse events. Additional research is needed to assess the clinical effectiveness and safety of polyHexaMethylene coated central venous catheters.

Tags

infection control, anti-bacterial agents, antibiotic prophylaxis, anti-infective agents, anti-infective agents, local, bacteremia, biguanides, catheterization, central venous, catheter-related infections, chlorhexidine, coated materials, biocompatible, disinfectants, fluorouracil, heparin, minocycline, polymers, rifampin, silver sulfadiazine, cardiovascular, medical devices, central venous access, catheter, catheter-associated infections, CVC, Coated, central venous catheter, Antibacterial, Antimicrobial, anti-infective