ABSTRACT
Background: Patients who use Permcath permanent catheter as the vascular access for hemodialysis are occasionally confronted with catheter-related infections. Permcath infections can lead to catheter removal in Haemodialysis patients. Successful use of a 'locked-in' antibiotic has decreased catheter infections. This study evaluates the impact of the intraluminal vancomycin in comparison with intravenous antibiotic administration
Material and Methods: This experimental nonrandomized controlled study included 67 end stage renal disease patients enrolled for HD from 2005 to 2007 at our hospitals. The patient was studied in to 2 groups. In the first group [intervention group], vancomycin was injected via each lumen of permcath, with IV Ceftriaxone for 7 days, and then oral antibiotics was administered according to the culture fore three weeks. If the culture was negative, Cefixime was administered. In the second group intravenous Vancomycin + intravenous Amikacin prescribed. In both groups, if the patients had it enough response after 72 hours, permcath was removed. Our endpoint is to assessment of catheter removal
Results: Patients characteristics didn't differ between 2 groups. Of 28 patients in group 1, 1 catheter removal, and of 39 patients in group2, 22 catheter removals were done. There is a significant reduction of catheter removal in the first group [p<0.001]
Conclusions: This study has shown that administration of Vancomycin via permcath is more effective than intravenous, and increase life time of catheter