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J Nephrol ; 36(7): 1889-1896, 2023 09.
Article in English | MEDLINE | ID: mdl-37140818

ABSTRACT

INTRODUCTION: Infection is the second leading cause of death in dialysis patients, with catheter-related bloodstream infection being the most serious. Exit Site Infection and Tunnel Infection are also related to the catheter. OBJECTIVE: To compare the infection rates achieved with the application of either topical gentamicin or placebo to the exit-site of tunneled catheters filled with locking solution in chronic hemodialysis patients. METHODS: This randomized double-blind clinical trial compared the application of 0.1% gentamicin versus placebo to the exit site of tunneled hemodialysis catheters filled with a prophylactic locking solution. A total of 91 patients were randomly allocated to 2 groups: placebo or 0.1% gentamicin. RESULTS: Mean patient age was 60.4 (+ 15.3) years, with predominance of males (60.4%). The main cause of chronic kidney disease was diabetes (40.7%). The rates of exit site infection (placebo = 30% vs. gentamicin = 34.1%, p = 0.821), and bloodstream infection (placebo = 22% vs. gentamicin = 17.1%, p = 0.60), as well as both exit site infection and bloodstream infection incidence density per 1000 catheter-days (p = 1) did not differ between groups. The infection-free curve was also similar in both groups. CONCLUSION: The application of topical 0.1% gentamicin to the exit site of tunneled catheters filled with lock solution did not reduce infectious complications when compared to topical placebo in patients on chronic hemodialysis.


Subject(s)
Catheter-Related Infections , Catheterization, Central Venous , Sepsis , Male , Humans , Middle Aged , Aged , Female , Gentamicins/therapeutic use , Catheter-Related Infections/prevention & control , Catheter-Related Infections/etiology , Double-Blind Method , Renal Dialysis/adverse effects , Sepsis/complications , Catheters, Indwelling/adverse effects , Catheterization, Central Venous/adverse effects
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