In a study appearing in a forthcoming issue of the Journal of the American Society Nephrology (JASN), Rodrigo Peixoto Campos, MD (Pontifícia Universidade Católica do Paraná, in Curitiba, Brazil) and colleagues show that kidney patients who use catheters during dialysis can fend off serious bacterial infections with Antibiotics. However, excessive antibiotic use may lead to drug resistance, resulting in the formation of “super bugs.”
The findings of a new randomized controlled clinical trial involving nearly 200 dialysis patients revealed that bacterial infections in dialysis patients can be safely treated using antibiotics that are not intended for other severe infections.
In order to prevent clot formation within the catheter between dialysis treatments, the device is “locked” by injecting the heparin (blood thinner) into the catheter. In this study, a comparison was made between heparin use, and a solution containing the antibiotic minocycline in combination with EDTA. While Minocycline is intended for acne treatment, EDTA acts by enhancing antibiotic action, combating fungal infections, and limiting blood clots. Around 50% of the patients were assigned to the heparin group, and the rest to the minocycline-EDTA combination group.
The major findings of the study revealed that:
• Bacterial infection was less likely to occur in patients in the minocycline-EDTA group compared to the heparin group.
• Over a period of 3 months, 19 patients in the heparin group had bacterial infections compared to only five of them in the minocycline-EDTA group.
• There was no functional difference between the catheters of both groups.
Dr. Campos said, “When a dialysis clinic cannot achieve lower rates of catheter-related bacterial infections with routine catheter care protocols, the use of a catheter lock solution of minocycline-EDTA may be the next step to reduce this major complication, without the apprehension of developing bacterial resistance to systemic antibiotics.”
Study co-authors include Marcelo Mazza do Nascimento, MD, PhD (Hospital Universitário Evangélico de Curitiba, in Curitiba, Brazil); Domingos Candiota Chula, MD (Clínica de Doenças Renais do Novo Mundo, in Curitiba, Brazil); and Miguel Carlos Riella, MD, PhD, FACP (Pontifícia Universidade Católica do Paraná and Hospital Universitário Evangélico de Curitiba, in Curitiba, Brazil).