Antimicrobial PICC systematic review
Abstract:
Background: Several studies have investigated the safety and efficacy of antimicrobial peripherally inserted central catheters (PICCs) and the results are conflicting. Therefore, in this systematic review and meta-analysis, we aimed to summarize and identify the effect of antimicrobial PICCs on central line-associated bloodstream infection (CLABSI) risk.
Methods: A systematic search of PubMed, Ovid MEDLINE, Ovid Embase, and Web of Science was performed to identify relevant studies up to December 2022.
Results: A total of nine studies were included for analysis. There were seven retrospective/prospective cohort studies and two randomized controlled trials. The nine studies involved 51,373 patients with PICCs. Among these patients, 6,563 (12.8%) anti-microbial coated/impregnated PICCs and 44,810 (87.2%) nonantimicrobial-impregnated (NAIP) PICCs were inserted. The meta-analysis showed that anti-microbial PICCs had a non-significant association with lower CLABSI risk compared with noncoated PICCs (RR = 0.67; 95% CI, 0.43-1.05). In the subgroup analysis, minocycline-rifampin- (RR = 0.30; 95% CI, 0.19- 0.49) or chlorhexidine-coated (RR = 0.61; 95% CI, 0.04- 8.55) PICCs showed an association with reduced risk of CLABSI. In the adult population, anti-microbial PICCs had a non-significant association with lower CLABSI risk (RR = 0.50; 95% CI, 0.20-1.22).
Conclusion: In conclusion, this systematic review and meta-analysis suggested that anti-microbial PICCs had a non-significant association with lower CLABSI risk compared with noncoated PICCs. Minocycline-rifampin- or chlorhexidine-coated PICCs showed an association with reduced risk of CLABSI.
Reference:
Wu Y, Liu Y, Wang B, Feng B. Efficacy of antimicrobial peripherally inserted central catheters in line-associated bloodstream infections: A systematic review and meta analysis. Am J Infect Control. 2023 Apr 21:S0196-6553(23)00330-9. doi: 10.1016/j.ajic.2023.04.163. Epub ahead of print. PMID: 37088441.