Abstract
Objective
To assess the effect of IV vancomycin perioperatively on early (within eight days) and overall rate of infections related to long term central venous catheters (CVC) in patients with acquired immunodeficiency syndrome (AIDS).
Methods
AIDS patients received IV vancomycin 500 mg immediately before and 500 mg 6 hours after insertion of a long term CVC. They were observed for eight days with blood cultures (peripheral and transcatheter), skin exit site and hub. Rates of early and late catheter-related infections were compared with those of a retrospective study of Hickman catheter-related infections in our hospital.
Results
Of 20 long term CVC inserted in 18 patients who received vancomycin prophylaxis, 5 developed early infections and 2 late infections (7 total; 35 percent) versus 7 and 9 respectively (16 total; 35 percent) of 46 Hickman catheters inserted in 44 AIDS controls. Staphylococcus aureus was responsible for 1 infection in the study group versus 7 of 7 early and 14 of 16 overall catheter infection in controls. Staphylococcus epidermidis was responsible for the other four early infections.
Conclusions
Vancomycin prophylaxis did not decrease risk of long term CVC infections in patients with AIDS. It reduced the frequency of S. aureus catheter infections at the expense of increased risk of S. epidermidis infections.
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