Intervention Review

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Antibiotic and other lock treatments for tunnelled central venous catheter-related infections in children with cancer

  1. Reineke A Schoot1,*,
  2. Elvira C van Dalen1,
  3. Cornelia H van Ommen2,
  4. Marianne D van de Wetering1

Editorial Group: Cochrane Childhood Cancer Group

Published Online: 25 JUN 2013

Assessed as up-to-date: 28 FEB 2012

DOI: 10.1002/14651858.CD008975.pub2


How to Cite

Schoot RA, van Dalen EC, van Ommen CH, van de Wetering MD. Antibiotic and other lock treatments for tunnelled central venous catheter-related infections in children with cancer. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD008975. DOI: 10.1002/14651858.CD008975.pub2.

Author Information

  1. 1

    Emma Children's Hospital / Academic Medical Center, Department of Paediatric Oncology, Amsterdam, Netherlands

  2. 2

    Emma Children's Hospital / Academic Medical Center, Department of Paediatric Haematology, Amsterdam, Netherlands

*Reineke A Schoot, Department of Paediatric Oncology, Emma Children's Hospital / Academic Medical Center, PO Box 22660, Amsterdam, 1100 DD, Netherlands. r.a.schoot@amc.uva.nl.

Publication History

  1. Publication Status: New
  2. Published Online: 25 JUN 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Atkinson 1998 {published data only}
  • Atkinson JB, Chamberlin K, Boody BA. A prospective randomized trial of urokinase as an adjuvant in the treatment of proven Hickman catheter sepsis. Journal of Pediatric Surgery 1998;33:714-6.
Dannenberg 2003 {published data only}
  • Dannenberg C, Bierbach U, Rothe A, Beer J, Korholz D. Ethanol-lock technique in the treatment of bloodstream infections in pediatric oncology patients with Broviac catheter. Journal of Pediatric Hematology/Oncology 2003;25:616-21.
La Quaglia 1994 {published data only}
  • La Quaglia MP, Caldwell C, Lucas A, Corbally M, Heller G, Steinherz L, et al. A prospective randomized double-blind trial of bolus urokinase in the treatment of established Hickman catheter sepsis in children. Journal of Pediatric Surgery 1994;29:742-5.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Abdelkefi 2007 {published data only}
  • Abdelkefi A, Achour W, Othman TB, Ladeb S, Torjman L, Lakhal A, et al. Use of heparin-coated central venous lines to prevent catheter-related bloodstream infection. Journal of Supportive Oncology 2007;5:273-8.
Abdelkefi 2008 {published data only}
  • Abdelkefi A, Chelli M, Achour W, Romdhane NB, Torjman L, Ladeb S, et al. [Catheter related bloodstream infection in haematological patients: a prospective, randomized study comparing heparin-coated with chlorhexidine and silver sulfadiazine impregnated central venous catheters]. American Society of Hematology Annual Meeting Abstracts, ASH. 2008:1174.
Akyüz 2010 {published data only}
  • Akyüz C, Kpeli S, Yagci-Kpeli B, Bykpamukcu M. Prophylactic taurolidine use in central venous catheters of pediatric cancer patients: A prospective randomized study from single center. Pediatric Blood and Cancer. 2010; Vol. 42nd Congress of the International Society of Pediatric Oncology, SIOP:949.
Al-Hathal 1989 {published data only}
Albanese 1993 {published data only}
Anoop 2009 {published data only}
  • Anoop P, Anjay MA. Towards evidence based medicine for paediatricians. Role of antibiotic line locks in the treatment of infected central venous access devices. Archives of Disease in Childhood 2009;94:556-9.
Aquino 2002 {published data only}
  • Aquino VM, Sandler ES, Mustafa MM, Steele JW, Buchanan GR. A prospective double-blind randomized trial of urokinase flushes to prevent bacteremia resulting from luminal colonization of subcutaneous central venous catheters. Journal of Pediatric Hematology/Oncology 2002;24:710-3.
Arora 2010 {published data only}
Ascher 1993 {published data only}
Ashkenazi 1992 {published data only}
Atay 2004 {published data only}
  • Atay AA, Kismet E, Karaoglu A, Kurekc AE, Baysallar M, Koseoglu V, et al. Comparison of cefepime and meropenem use in treatment of neutropenic fever. Gulhane Medical Journal 2004;46:102-5.
Attal 1991 {published data only}
  • Attal M, Schlaifer D, Rubie H, Huguet F, Charlet JP, Bloom E, et al. Prevention of gram-positive infections after bone marrow transplantation by systemic vancomycin: a prospective, randomized trial. Journal of Clinical Oncology 1991;9:865-70.
Averbuch 2008 {published data only}
  • Averbuch D, Makhoul R, Rotshild V, Weintraub M, Engelhard D. Empiric treatment with once-daily cefonicid and gentamicin for febrile non-neutropenic pediatric cancer patients with indwelling central venous catheters. Journal of Pediatric Hematology/Oncology 2008;30:527-32.
Backeljauw 1991 {published data only}
  • Backeljauw PF, Moodie DS, Murphy DJ Jr. High-dose urokinase therapy for the lysis of a central venous catheter-related thrombus in a young patient with Hodgkin's disease. Clinical Pediatrics 1991;30:274-7.
Bagnall-Reeb 1990 {published data only}
  • Bagnall-Reeb HA, Ruccione K. Management of cutaneous reactions and mechanical complications of central venous access devices in pediatric patients with cancer: algorithms for decision making. Oncology Nursing Forum 1990;17:677-81.
Ball 1993 {published data only}
  • Ball LM, Siddal S, van Saenen H. Teicoplanin in home therapy of the terminally ill child. European Journal of Haematology Supplementum 1993;54:14-7.
Barriga 1997 {published data only}
  • Barriga FJ, Varas M, Potin M, Sapunar F, Rojo H, Martinez A, et al. Efficacy of a vancomycin solution to prevent bacteremia associated with an indwelling central venous catheter in neutropenic and non-neutropenic cancer patients. Medical and Pediatric Oncology 1997;28:196-200.
Berger 2004 {published data only}
Beutel 2005 {published data only}
  • Beutel K, Simon A. Diagnostics and management of central venous line infections in pediatric cancer patients [Diagnostik und therapie katheter-assoziierter infektionen in der pädiatrischen onkologie]. Klinische Padiatrie 2005;217 Suppl 1:S91-100.
Boughton 1989 {published data only}
  • Boughton BJ, Harris RI, Brown RM, Webberley J, Baglin TP, Jackson N, et al. Gentamicin and low dose piperacillin in febrile neutropenic patients. Journal of Antimicrobial Chemotherapy 1989;24:45-51.
Butt 2004 {published data only}
  • Butt T, Afzal RK, Ahmad RN, Hussain I, Anwar M. Central venous catheter-related bloodstream infections in cancer patients. Journal of the College of Physicians and Surgeons Pakistan 2004;14:549-52.
Castagnola 2001 {published data only}
  • Castagnola E, Fioredda F, Barretta MA, Pescetto L, Garaventa A, Lanino E, et al. Bacillus sphaericus bacteraemia in children with cancer: case reports and literature review. Journal of Hospital Infection 2001;48:142-5.
Castagnola 2010 {published data only}
  • Castagnola E, Bandettini R, Lorenzi I, Caviglia I, Macrina G, Tacchella A. Catheter-related bacteremia caused by methicillin-resistant coagulase negative staphylococci with elevated minimal inhibitory concentration for vancomycin. Pediatric Infectious Disease Journal 2010;29(11):1047-8.
Cesaro 2009 {published data only}
  • Cesaro S, Tridello G, Cavaliere M, Magagna L, Gavin P, Cusinato R, et al. Prospective, randomized trial of two different modalities of flushing central venous catheters in pediatric patients with cancer. Journal of Clinical Oncology 2009;27:2059-65.
Chamberlain 2005 {published data only}
Chatzinikolaou 2003 {published data only}
  • Chatzinikolaou I, Zipf TF, Hanna H, Umphrey J, Roberts WM, Sherertz R, et al. Minocycline-ethylenediaminetetraacetate lock solution for the prevention of implantable port infections in children with cancer. Clinical Infectious Diseases 2003;36:116-9.
Chen 2009 {published data only}
  • Chen WT, Liu TM, Wu SH, Tan TD, Tseng HC, Shih CC. Improving diagnosis of central venous catheter-related bloodstream infection by using differential time to positivity as a hospital-wide approach at a cancer hospital. Journal of Infection 2009;59:317-23.
Chen 2011 {published data only}
  • Chen IC, Hsu C, Chien SF, Kao HF, Jhang SY, Chen YC, et al. Characterization of permanently implantable venous port associated bloodstream infection (PABSI) in patients with solid cancers: a case-control study. Multinational Association of Supportive Care in Cancer: International symposium on supportive care in cancer, MASCC. 2011:S262.
Cherif 2004 {published data only}
  • Cherif H, Bjorkholm M, Engervall P, Johansson P, Ljungman P, Hast R, et al. A prospective, randomized study comparing cefepime and imipenem-cilastatin in the empirical treatment of febrile neutropenia in patients treated for haematological malignancies. Scandinavial Journal of Infectious Diseases 2004;36:593-600.
Cherrick 1995 {published data only}
Chiu 1998 {published data only}
  • Chiu HH, Huang LM, Lee PI, Lee CY. Bacteremia and fungemia in hematological and oncological children with neutropenic fever: two-year study in a medical center. Journal of Microbiology, Immunology and Infection 1998;31:101-6.
Daghistani 1996 {published data only}
Dias 2008 {published data only}
  • Dias MBS, Habert AB, Borrasca V, Stempliuk V, Ciolli A, Araújo RE, et al. Salvage of long-term central venous catheter during an outbreak of pseudomonas putida and Stenotrophomonas maltophilia infections associated with contaminated heparin catheter-lock solution. Infection Control and Hospital Epidemiology 2008;29(2):1250-30.
Dillon 2004 {published data only}
  • Dillon PW, Jones GR, Bagnall-Reeb HA, Buckley JD, Wiener ES, Haase GM. Prophylactic urokinase in the management of long-term venous access devices in children: a Children's Oncology Group study. Journal of Clinical Oncology 2004;22:2718-23.
Doganis 2007 {published data only}
  • Doganis D, Portsidis A, Lebessi E, Bouhoutsou D, Baka M. [Factors related to bloodstream infections in children with cancer]. 39th Congress of the International Society of Pediatric Oncology, SIOP. 2007:483.
Douard 1991 {published data only}
  • Douard MC, Arlet G, Leverger G, Paulien R, Waintrop C, Clementi E, et al. Quantitative blood cultures for diagnosis and management of catheter-related sepsis in pediatric hematology and oncology patients. Intensive Care Medicine 1991;17:30-5.
Dunn 2008 {published data only}
Elting 1990 {published data only}
Giacchino 2007 {published data only}
Haffar 1984 {published data only}
Haimi-Cohen 2001 {published data only}
  • Haimi-Cohen Y, Husain N, Meenan J, Karayalcin G, Lehrer M, Rubin LG. Vancomycin and ceftazidime bioactivities persist for at least 2 weeks in the lumen in ports: simplifying treatment of port-associated bloodstream infections by using the antibiotic lock technique. Antimicrobial Agents and Chemotherapy 2001;45(5):1565-7.
Handrup 2010 {published data only}
  • Handrup MM, Møller JK, Schrøder H. [Catheter-related bloodstream infections in children with cancer admitted with fever]. 42nd Congress of the International Society of Pediatric Oncology, SIOP. 2010:978.
Henrickson 2000 {published data only}
  • Henrickson KJ, Axtell RA, Hoover SM, Kuhn SM, Pritchett J, Kehl SC, et al. Prevention of central venous catheter-related infections and thrombotic events in immunocompromised children by the use of vancomycin/ciprofloxacin/heparin flush solution: A randomized, multicenter, double-blind trial. Journal of Clinical Oncology 2000;18:1269-78.
Jones 2001 {published data only}
  • Jones GR, Dillon PW, Bagnall RH, Dillon P, Corless R. Urokinase for prevention of central venous catheter occlusions and infections: results of the Children's Cancer Group Study CCG-S921. Pediatric Research 2001;49:215A.
Kalmanti 2002 {published data only}
  • Kalmanti M, Germanakis J, Stiakaki E, Syfridaki C, Christidou A, Tsetis D, et al. Prophylaxis with urokinase in pediatric oncology patients with central venous catheters. Journal of Pediatric Hematology/Oncology 2002;19:173-9.
Kaplan 2003 {published data only}
  • Kaplan SL, Deville JG, Yogev R, Morfin MR, Wu E, Adler S, et al. Linezolid versus vancomycin for treatment of resistant Gram-positive infections in children. Pediatric Infectious Disease Journal 2003;22:677-86.
Kefeli 2009 {published data only}
Kethireddy 2008 {published data only}
  • Kethireddy S, Safdar N. Urokinase lock or flush solution for prevention of bloodstream infections associated with central venous catheters for chemotherapy: a meta-analysis of prospective randomized trials. Journal of Vascular Access 2008;9:51-7.
Ketley 1995 {published data only}
Kinsey 1998 {published data only}
  • Kinsey SE. Experience with teicoplanin in non-inpatient therapy in children with central line infections. European Journal of Haematology Supplementum 1998;62:11-4.
Lee 2005 {published data only}
Ley 1996 {published data only}
  • Ley BE, Jalil N, McIntosh J, Smart A, Wilson M, Foot AB, et al. Bolus or infusion teicoplanin for intravascular catheter associated infections in immunocompromised patients?. Journal of Antimicrobials and Chemotherapy 1996;38:1091-5.
Menichetti 1990 {published data only}
Norville 2006 {published data only}
  • Norville R, Horvath B, Lee D, Hyde A, Gregurich M, Hilburn J, et al. [Hub colonization of central line catheter in children with cancer]. American Society of Clinical Oncology Annual Meeting Proceedings, ASCO. 2006:18530.
O'Brien 1988 {published data only}
  • O'Brien AJ, Fenelon LE, O'Dwyer R, McCann SR, Daly PA. A comparative study of latamoxef disodium and gentamicin versus piperacillin and gentamicin in febrile granulocytopenic patients. British Journal of Clinical Practice 1988;42:56-60.
Paulus 2005 {published data only}
  • Paulus SC, van Saene HK, Hemsworth S, Hughes J, Ng A, Pizer BL. A prospective study of septicaemia on a paediatric oncology unit: a three-year experience at The Royal Liverpool Children's Hospital, Alder Hey, UK. European Journal of Cancer 2005;41:2132-40.
Raad 1997 {published data only}
  • Raad I, Darouiche R, Dupuis J, Abi-Said D, Gabrielli A, Hachem R, et al. Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and blood stream infections. A randomized, double-blind trial. Annals of Internal Medicine 1997;127:267-74.
Raad 2003 {published data only}
Reilly 2004 {published data only}
Riikonen 1993 {published data only}
  • Riikonen P, Saarinen UM, Lahteenoja KM, Jalanko H. Management of indwelling central venous catheters in pediatric cancer patients with fever and neutropenia. Scandinavian Journal of Infectious Diseases 1993;25:357-64.
Rubin 1999 {published data only}
  • Rubin LG, Shih S, Shende A, Karayalcin G, Lanzkowsky P. Cure of implantable venous port-associated bloodstream infections in pediatric hematology-oncology patients without catheter removal. Clinical Infectious Diseases 1999;29:102-5.
Russell 1990 {published data only}
  • Russell L, Craig JI, MacKinlay GA, Eden OB. The use of central venous catheters in paediatric oncology--a cautionary tale. Scottish Medical Journal 1990;35:11-4.
Ruud 2006 {published data only}
Safdar 2007 {published data only}
  • Safdar A, Rodriguez GH, Raval DS, Bodey GP, Rolston KV. [Polymicrobial bloodstream infections (PBI): An under-realized complication in patients with cancer (2005-2006)]. American Society of Clinical Oncology Annual Meeting Proceedings, ASCO. 2007:19590.
Safdar 2006 {published data only}
  • Safdar N, Maki DG. Use of vancomycin-containing lock or flush solutions for prevention of bloodstream infection associated with central venous access devices: a meta-analysis of prospective, randomized trials. Clinical Infectious Diseases 2006;43:474-84.
Sanchez-Munoz 2005 {published data only}
  • Sanchez-Munoz A, Aguado JM, Lopez-Martin A, Lopez-Medrano F, Lumbreras C, Rodriguez FJ, et al. Usefulness of antibiotic-lock technique in management of oncology patients with uncomplicated bacteremia related to tunneled catheters. European Journal of Clinical Microbiology and Infectious Diseases 2005;24:291-3.
Scheinemann 2010 {published data only}
  • Scheinemann K, Doyle JJ, Allen U, Ethier MC, Dupuis LL, Richardson SE, et al. Contribution of peripheral blood cultures to central catheter cultures in febrile children with cancer. 40th Congress of the International Society of Pediatric Oncology, SIOP. 2008:164.
Schierholz 2010 {published data only}
  • Schierholz JM, Nagelschmidt K, Nagelschmidt M, Lefering R, Yucel N, Beuth J. Antimicrobial central venous catheters in oncology: efficacy of a rifampicin-miconazole-releasing catheter. Anticancer Research 2010;30:1353-8.
Schmid 1991 {published data only}
Schwartz 1990 {published data only}
  • Schwartz C, Henrickson KJ, Roghmann K, Powell K. Prevention of bacteremia attributed to luminal colonization of tunneled central venous catheters with vancomycin-susceptible organisms. Journal of Clinical Oncology 1990;8:1591-7.
Shivnan 1991 {published data only}
  • Shivnan JC, McGuire D, Freedman S, Sharkazy E, Bosserman G, Larson E, et al. A comparison of transparent adherent and dry sterile gauze dressings for long-term central catheters in patients undergoing bone marrow transplant. Oncology Nursing Forum 1991;18:1349-56.
Simon 1994 {published data only}
Simon 2006 {published data only}
Simon 2008a {published data only}
  • Simon A, Ammann RA, Wiszniewsky G, Bode U, Fleischhack G, Besuden MM. Taurolidine-citrate lock solution (TauroLock) significantly reduces CVAD-associated grampositive infections in pediatric cancer patients. BMC Infectious Diseases 2008;8:102.
Simon 2008b {published data only}
  • Simon A, Bode U, Lieber K, Beutel K, Fleischhack G. Review and update of the use of urokinase in the prevention and management of CVAD-related complications in pediatric oncology patients. American Journal of Infection Control 2008;36:54-8.
Smith 1989 {published data only}
  • Smith SR, Cheesbrough J, Spearing R, Davies JM. Randomized prospective study comparing vancomycin with teicoplanin in the treatment of infections associated with Hickman catheters. Antimicrobial Agents and Chemotherapy 1989;33:1193-7.
Snaterse 2010 {published data only}
  • Snaterse M, Ruger W, Scholte op Reimer WJM, Lucas C. Antibiotic-based catheter lock solutions for prevention of catheter-related bloodstream infection: a systematic review of randomised controlled trials. Journal of Hospital Infection 2010;75:1-11.
Souza Dias 2008 {published data only}
  • Souza Dias MB, Bernardes Habert A, Borrasca V, Stempliuk V, Ciolii A, Araújo RE, et al. Salvage of long-term central venous catheters during an outbreak of Pseudomonas putida and Stenotrophomonas maltophilia infections associated with contaminated heparin catheter-lock solution. Infection Control and Hospital Epidemiology 2008;29(2):125-30.
Stoneham 2007 {published data only}
  • Stoneham S, Skinner R, Johnson G, Millar M. [Diagnosis of central venous access device (CVAD) associated bacteraemia using quantitative 16S rDNA detection]. 39th Congress of the International Society of Pediatric Oncology, SIOP. 2007:511.
Tobiansky 1997 {published data only}
Viscoli 1988 {published data only}
  • Viscoli C. Aspects of infections in children with cancer. Recent Results in Cancer Research 1988;108:71-81.
Wiener 1992 {published data only}
  • Wiener E, McGuire P, Stolar C, RIch H, Albo V, Ablin AR, et al. The CCSG prospective study of venous access devices: an analysis of insertions and causes for removal. Journal of Pediatric Surgery 1992;27(2):155-64.
Wiernikowski 1991 {published data only}
  • Wiernikowski JT, Elder-Thornley D, Dawson S, Rothney M, Smith S. Bacterial colonization of tunneled right atrial catheters in pediatric oncology: a comparison of sterile saline and bacteriostatic saline flush solutions. American Journal of Pediatric Hematologogy/Oncology 1991;13:137-40.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Adler 2006
  • Adler A, Yaniv I, Steinberg R, Solter E, Samra Z, Stein J, et al. Infectious complications of implantable ports and Hickman catheters in paediatric haematology-oncology patients. Journal of Hospital Infection 2006;62(3):358-65.
Bagnall-Reeb 2004
  • Bagnall-Reeb H. Evidence for the use of the antibiotic lock technique. Journal of Infusion Nursing 2004;27(2):118-22.
Barbaric 2004
Bell 2006
Bernardi 2005
  • Bernardi M, Cavaliere M, Cesaro S. The antibiotic-lock therapy in oncoematology pediatric unit [L'uso dell'antibiotic-therapy in un reparto di oncoematologia pediatrica]. Assistenza Infermieristica e Ricerca 2005;24(3):127-31.
Bradshaw 2008
  • Bradshaw JH, Puntis JWL. Taurolidine and catheter-related bloodstream infection: a systematic review of literature. Journal of Pediatric Gastroenterology and Nutrition 2008;47:179-86.
Carratala 2002
Cesaro 2004
  • Cesaro S, Corro R, Pelosin A, Gamba P, Zadra N, Fusaro F, et al. A prospective survey on incidence and outcome of Broviac/Hickman catheter-related complications in pediatric patients affected by hematological and oncological diseases. Annals of Hematology 2004;83(3):183-8.
Cesaro 2007
  • Cesaro S, Cavaliere M, Spiller M, Rossi L, Magagna L, Gavin P, et al. A simplified method of antibiotic lock therapy for Broviac-Hickman catheters using a CLC 2000 connector device. Supportive Care in Cancer 2007;15:95-9.
Chaudhury 2012
Chu 2012
  • Chu HP, Brind J, Tomar R, Hill S. Significant reduction in central venous catheter-related bloodstream infections in children on HPN after starting treatment with taurolidine line lock. Journal of Pediatric Gastroenterology and Nutrition 2012;55(4):403-7.
Cober 2010
  • Cober MP, Kovacevich DS, Teitelbaum DH. Ethanol-lock therapy for the prevention of central venous access device infections in pediatric patients with intestinal failure. Journal of Parenteral and Enteral Nutrition 2011;35(1):67-73.
Cochrane Handbook
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Costa 2004
Cuntz 2002
  • Cuntz D, Michaud L, Guimber D, Husson MO, Gottrand F, Turck D. Local antibiotic lock for the treatment of infections related to central catheters in parenteral nutrition in children. Journal of Parenteral and Enteral Nutrition 2002;26(2):104-8.
De Sio 2004
  • De Sio L, Jenkner A, Milano GM, Ilari I, Fidani P, Castellano A, et al. Antibiotic lock with vancomycin and urokinase can successfully treat colonized central venous catheters in pediatric cancer patients. Pediatric Infectious Disease Journal 2004;23(10):963-5.
Droste 2003
  • Droste JC, Jeraj HA, MacDonald A, Farrington A. Stability and in vitro efficacy of antibiotic-heparin lock solutions potentially useful for treatment of central venous catheter-related sepsis. Journal of Antimicrobial Chemotherapy 2003;51:849-55.
Dümichen 2012
  • Dümichen MJ, Seeger K, Lode HN, Kühl JS, Ebell W, Degenhardt P, et al. Randomized controlled trial of taurolidine citrate versus heparin as catheter lock solution in paediatric patients with haematological malignancies. Journal of Hospital Infection 2012;80:304-9.
Eggiman 2004
Fleischhack 2001a
  • Fleischhack G, Schmidt-Niemann M, Wulff B, Havers W, Marklein G, Hasan C, et al. Piperacillin, beta-lactam inhibitor plus gentamicin as empirical therapy of a sequential regimen in febrile neutropenia of pediatric cancer patients. Supportive Care in Cancer 2001;9(5):372-9.
Fleischhack 2001b
  • Fleischhack G, Hartmann C, Simon A, Wulff B, Havers W, Marklein G, et al. Meropenem versus ceftazidime as empirical monotherapy in febrile neutropenia of paediatric patients with cancer. Journal of Antimicrobial Chemotherapy 2001;47(6):841-53.
Flynn 2000
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Franklin 2004
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Fratino 2005
  • Fratino G, Molinari AC, Parodi S, Long S, Saracco P, Castagnola E, et al. Central venous catheter-related complications in children with oncological/hematological diseases: an observational study of 418 devices. Annals of Oncology 2005;16(4):648-54.
Hachem 2002
Hann 1997
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Higgins 2003
Johnson 1994
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Jones 1993
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Jones 1996
Jones 2010
  • Jones BA, Hull MA, Richardson DS, Zurakowski D, Gura K, Fitzgibbons SC, et al. Efficacy of ethanol locks in reducing central venous catheter infections in pediatric patients with intestinal failure. Journal of Pediatric Surgery 2010;45:1287-93.
Kayton 2010
  • Kayton ML, Garmey EG, Ishill NM, Cheung NV, Kushner BH, Kramer K, et al. Preliminary results of a phase I trial of prophylactic ethanol-lock administration to prevent mediport catheter-related bloodstream infections. Journal of Pediatric Surgery 2010;45:1961-66.
Koldehoff 2004
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Laird 2005
Maiefski 2009
Maki 2006
  • Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: A systematic review of 200 published prospective studies. Mayo Clinic Proceedings 2006;81(9):1159-71.
McCarthy 1995
Mermel 2001
  • Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N, Harris JS, et al. Guidelines for the management of intravascular catheter-related infections. Infection Control and Hospital Epidemiology 2001;22(4):222-42.
Mermel 2009
  • Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP, et al. IDSA Guidelines for the diagnosis and management of intravascular catheter-related bloodstream infection reply. Clinical Infectious Diseases 2009;49(11):1771-2.
Messing 1988
  • Messing B, Peitra-Cohen S, Debure A, Beliah M, Bernier JJ. Antibiotic-lock technique: a new approach to optimal therapy for catheter-related sepsis in home-parenteral nutrition patients. Journal of Parenteral and Enteral Nutrition 1988;12(2):185-9.
Module CCG
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Mouw 2008
  • Mouw E, Chessman K, Leshner A, Tagge E. Use of an ethanol lock to prevent catheter-related infections in children with short bowel syndrome. Journal of Pediatric Surgery 2008;43:1025-9.
O'Grady 2002
  • O'Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases 2002;35(11):1281-307.
Oliveira 2012
  • Oliveira C, Nasr A, Brindle M, Wales PW. Ethanol locks to prevent catheter-related bloodstream infections in parenteral nutrition: a meta-analysis. Pediatrics 2012;129:1-12.
Onland 2006
  • Onland W, Shin CE, Fustar S, Rushing T, Wong WY. Ethanol-lock technique for persistent bacteremia of long-term intravascular devices in pediatric patients. Archives of Pediatrics and Adolescent Medicine 2006;160(10):1049-53.
Plourde 2011
  • Plourde R, Gothard D, Markowski A, Cockrell E. Efficacy of ethanol locks for treatment of central venous catheter infections in pediatric oncology patients. 24th Annual Meeting of the American Society of Pediatric Hematology Oncology, ASPHO. 2011:940.
Qu 2009
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