Antimicrobials: Healthcare's Silver Bullet Against HAIs?

Rupp et al. (2005) sought to ascertain the effectiveness of a second-generation antiseptic-coated central venous catheter in the prevention of microbial colonization and infection, as well as the safety and tolerability of this device, the microbiology of infected catheters; and the propensity for the development of antiseptic resistance. The study was a multi-center, randomized, double-blind, controlled trial. Patients received either a standard catheter or a catheter coated with chlorhexidine and silver sulfadiazine. Patients with the two types of catheters had similar demographic features, clinical interventions, laboratory values, and risk factors for infection. Antiseptic catheters were less likely to be colonized at the time of removal compared with control catheters (13.3 versus 24.1 colonized catheters per 1,000 catheter-days). The rate of catheter-related bloodstream infection was 1.24 per 1,000 catheter-days for the control group versus 0.42 per 1,000 catheter-days for the antiseptic catheter group. Coagulase-negative staphylococci and other gram-positive organisms were the most frequent microbes to colonize catheters. Rupp et al. concluded, “The second-generation chlorhexidine/silver sulfadiazine catheter is well tolerated. Antiseptic coating appears to reduce microbial colonization of the catheter compared with an uncoated catheter.”