Antimicrobial Central Venous Catheters: A Qualitative Review of the Literature and Economic Assessment

• Objective: To evaluate the effectiveness of antimicrobialassociated central venous catheters (CVCs) and to estimate costs related to their use. • Method: Review of the literature. The clinical database from the University HealthSystem Consortium (UHC) was used to conduct a retrospective analysis of clinical and economic outcomes in adult patients who had a CVC placed while in the intensive care unit (ICU). • Outcome measures: For the literature review, catheter colonization and CVC-related blood stream infection. For the UHC analysis, inhospital mortality, length of stay, number of ICU days, and cost of hospitalization. • Results: A total of 13 trials were included in the review. Eight showed that rate of catheter colonization was significantly reduced in recipients of antimicrobial catheters, while 2 demonstrated significant reductions in the incidence of bacteremia or septicemia compared with those who had standard devices inserted. In the UHC analysis, length of total hospital stay and length of ICU stay for infected patients (28.8 ± 32.2 days and 14.6 ± 17.1 days, respectively) was significantly longer compared with noninfected patients (18.5 ± 19.7 days and 9 ± 12. days, respectively; P < 0.001 for both). • Conclusion: Antimicrobial-associated CVCs are an effective approach to reducing the incidence of catheter colonization when they are inserted under full barrier precautions and are maintained using scrupulous infection control procedures. Some data indicate that these devices also reduce the incidence of CVCassociated bacteremia or septicemia, although the evidence for this conclusion is not as strong.