Antibiotics Before Removal of Percutaneously Inserted Central Venous Catheters Reduces Clinical Sepsis in Premature Infants

Gail E Reynolds; Sarah B Tierney; Jonathan M Klein

doi:10.5863/1551-6776-20.3.203

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Antibiotics Before Removal of Percutaneously Inserted Central Venous Catheters Reduces Clinical Sepsis in Premature Infants

Journal article

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Antibiotics Before Removal of Percutaneously Inserted Central Venous Catheters Reduces Clinical Sepsis in Premature Infants

Gail E Reynolds, Sarah B Tierney and Jonathan M Klein

The journal of pediatric pharmacology and therapeutics, Vol.20(3), pp.203-209

2015

DOI: 10.5863/1551-6776-20.3.203

PMCID: PMC4471714

PMID: 26170772

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https://doi.org/10.5863/1551-6776-20.3.203View

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Abstract

OBJECTIVES: Evaluate the incidence of postcatheter removal clinical sepsis when antibiotics were infused prior to the removal of percutaneously inserted central venous catheters (PICCs). METHODS: A retrospective chart review of premature neonates (n = 196) weighing ≤1250 g at birth with 218 PICC line removals in the presence or absence of antibiotics at a tertiary level neonatal intensive care unit (NICU) between January 1, 2010, and May 31, 2012. Charts were reviewed looking for the presence of clinical sepsis defined as a sepsis workup including white blood cell count, differential, C-reactive protein, blood and/or cerebral spinal fluid (CSF), and urine cultures along with at least 48 hours of antibiotic therapy given within 72 hours after removal of a PICC line. Antibiotics were considered present at line removal if given within 12 hours before catheter removal either electively or at completion of a planned course. RESULTS: When antibiotics were given within 12 hours before PICC line removal, only 2% of the line removal episodes (1/48) resulted in a neonate developing clinical sepsis versus 13% (21/165) when no antibiotics were given prior to removal (p = 0.03, Fisher's exact test). Despite the increased use of elective antibiotics with line removal, there was no increase in total antibiotic usage due to the overall decrease in episodes of clinical sepsis or changes in antibiogram susceptibility patterns. CONCLUSIONS: There was an 11% absolute decrease and a 6-fold relative decrease in postcatheter removal clinical sepsis events in premature neonates who received antibiotics prior to PICC line removal.

prophylactic antibiotics

Clinical Investigations

neonatal sepsis

PICC removal

Details

Title: Subtitle: Antibiotics Before Removal of Percutaneously Inserted Central Venous Catheters Reduces Clinical Sepsis in Premature Infants
Creators: Gail E Reynolds - Stead Family Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
Sarah B Tierney - Department of Pharmaceutical Care, University of Iowa Children's Hospital, Iowa City, Iowa
Jonathan M Klein - Stead Family Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
Resource Type: Journal article
Publication Details: The journal of pediatric pharmacology and therapeutics, Vol.20(3), pp.203-209
DOI: 10.5863/1551-6776-20.3.203
PMID: 26170772
PMCID: PMC4471714
NLM abbreviation: J Pediatr Pharmacol Ther
ISSN: 1551-6776
eISSN: 2331-348X
Publisher: Pediatric Pharmacy Advocacy Group
Alternative title: Antibiotics for PICC Line Removal
Language: English
Date published: 2015
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093364802771

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