Review of taurolidine lock solution for CRBSI reduction in pediatric patients – CE activity

"Taurolidine lock solutions have been used to decrease catheter-related bloodstream infections (CRBSIs) in both adult and pediatric patients" Sun et al (2020).
Abstract:

Infection is one of the most commonly described complications, and a major cause of morbidity and mortality in pediatric patients treated using central venous catheters (CVCs). Taurolidine lock solutions have been used to decrease catheter-related bloodstream infections (CRBSIs) in both adult and pediatric patients. The purpose of this study was to systematically search the literature and conduct a meta-analysis to determine the efficacy of taurolidine in reducing CRBSI in children. We conducted an electronic search of the PubMed, EMBASE, Cochrane Library, TRIP Database, CINAHL, and Google Scholar databases for articles published up to 1st November 2019. Eligible studies included randomized controlled trials (RCTs) comparing the effects of taurolidine with control for preventing CRBSI in pediatric patients. Four studies were included. Our results indicated a statistical significant reduction in the total number of CRBSI with taurolidine as compared to control (RR: 0.23; 95% CI:0.13, 0.40; I2 = 0%; P<0.00001). The pooled analysis also indicated a statistical significant reduction in the incidence of CRBSI (defined as the number of CRBSI events/1000 catheter days) in the taurolidine group (MD: -1.12; 95% CI:-1.54, -0.71; I2 = 1%; P<0.00001). The number of catheters removed due to infection or suspected infection was not significantly different between the two groups (RR: 0.68; 95% CI:0.22, 2.10; I2 = 56%; P = 0.50) (Fig 5). The quality of the included studies was not high. The use of taurolidine as a catheter locking solution may significantly reduce CRBSI in pediatric patients. However, the quality of current evidence is not high and further high-quality large scale RCTs are needed to corroborate our results.

Reference:

Sun, Y., Wan, G. and Liang, L. (2020) Taurolidine lock solution for catheter-related bloodstream infections in pediatric patients: A meta-analysis. PLoS One. 15(4), p.e0231110. doi: 10.1371/journal.pone.0231110.

Continuing Education Activity

Welcome to the IVTEAM continuing education multiple-choice quiz on Taurolidine in pediatric patients - CE activity. Once completed, you will be emailed the results of the quiz. We recommend you retain the email as proof of your continuing professional development.

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1. What is mortality rates associated with CRBSI?
2. The authors state that the advantage of a locking solution is that it..?
3. The authors state... "Several factors can influence the risk of CRBSI in patients with CVCs. These include the patient’s medical history, duration of catheterization, frequency and duration of locking solutions, use of other measures, prophylactic antibiotics, etc. Fill in the blank?
4. What was the level of CRBSI risk reduction between the taurolidine group and the control group?
5. What is the range of antimicrobial activity associated with Taurolidine?

Thank you for completing the Taurolidine in pediatric patients - CE activity multiple-choice quiz on the June 6, 2020.



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