Antimicrobial lock solution

Sodemann K, Polaschegg HD, Feldmer B. Two years experience with Dialock and CLS (a new antimicrobial lock solution). Blood Purif 2001 19(2) 251. ... 

Yahav D, Rozen-Zvi B, Gafter-Gvili A, Leibo-vici L, Gafter U, Paul M Antimicrobial lock solutions for the prevention of infections associated with intravascular catheters in patients undergoing hemodialysis systematic review and meta-analysis of randomized, controlled trials. Chn Infect Dis 2008 47 83-93. 

Antimicrobial lock solutions may decrease the incidence of CRB, but their routine use not only increases the risk of systemic toxicity, but also causes the development of resistant organisms. Preliminary results suggest that a novel antimicrobial and antithrombotic solution may help with maintaining patency, while decreasing CRB. However, the ideal catheter lock solution would be one that prevents infections and thrombosis safely and effectively, and economically viable. Recent developments have led to improvements in the development of catheter locking solutions, but the search for the perfect solution is still ongoing. 

Catheter-related bloodstream infections are reduced by interdialytic locking with taurolidine, a nontoxic antimicrobial agent Although the use of a formulation of 1.35% taurolidine in 4% citrate, compared to 5,000 U/ml heparin, was associated with a greater need for thrombolysis to maintain catheter patency [32], the addition of 500 U/ml heparin to taurolidine-citrate solution avoided the need for thrombolysis without increasing bacteremia, with catheter patency comparable to heparin 5,000 U/ml [33]. A taurolidine-citrate (4%)-urokinase (25,000 U) lock solution is now available. 

Maki DG, et al A novel antimicrobial and antithrombotic lock solution for hemodialysis catheters a multi-center, controlled, randomized trial. Crit Care Med 2011 39 613-620. 

Catheter-related bacteraemia (CRB) and catheter dysfxmction are major sources of morbidity and mortality when central venous catheters (CVCs) are used as long-term vascular access devices in haemodialysis patients. Attempts have been made to minimise these complications by the prophylactic use of catheter locking solutions. The current study aims to describe the recent advances in the field of lock solutions and discusses the benefits and risks associated with the routine use of antimicrobial and/or antithrombotic lock solutions [ll J. These solutions may improve patency and CRB, but at the same time, these may be cost-prohibitive. 

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