Introduction

Data concerning the use of peripherally inserted central catheters (PICC) for the administration of intravenous (IV) antimicrobials in the acute care setting is scarce.

Methods

We performed a single-center retrospective case–control study (1:1). Case subjects were defined as patients who received IV antimicrobial treatment through a PICC line placed and maintained by specifically trained nurses (PICC group). Control subjects were defined as patients who received antimicrobial therapy by a peripheral or a central venous catheter (CVC) (control group). Control subjects were matched by type of antimicrobial, causative microorganism of the infection that was being treated and duration of treatment. An event leading to undesired catheter removal (ELUCR) was defined as any circumstance which lead to the removal of the indwelling catheter other than the completion of the scheduled course of antimicrobial therapy.

Results

The study included 50 patients in each group. The total follow-up time was 1376 catheter-days for the PICC group and 1362 catheter-days for the control group. We observed a significantly lower incidence of ELUCR in the PICC group (0.2 versus 7.7 events per 100 catheter-days; P < 0.001). When the incidence of ELUCR was analyzed according to the duration of indwelling catheterisation for each type of catheter (divided into one-week intervals), differences between both groups were also significant (P-values ≤ 0.001 for the first three weeks of treatment). During the second week of IV treatment, only one patient in the PICC group (2.1%) developed an ELUCR compared to 19 (38.8%) in the control group (P < 0.001).

Conclusions

A PICC placed and maintained by a dedicated nursing team is an excellent alternative to peripheral venous catheters or CVCs for administrating antimicrobial therapy for both short and long periods of treatment.

中文翻译：

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由专门的护理团队放置和维护的外周插入中心静脉导管，用于进行抗菌治疗与另一种导管的对比：一项回顾性病例对照研究。

介绍

关于在急性护理环境中使用外周插入中心导管 (PICC) 进行静脉注射 (IV) 抗菌药物的数据很少。

方法

我们进行了一项单中心回顾性病例对照研究 (1:1)。病例受试者被定义为通过由经过专门培训的护士（PICC 组）放置和维护的 PICC 管线接受静脉抗生素治疗的患者。对照组被定义为接受外周或中心静脉导管（CVC）抗菌治疗的患者（对照组）。对照受试者按抗菌素类型、正在治疗的感染的致病微生物和治疗持续时间进行匹配。导致不希望的导管移除(ELUCR)的事件被定义为导致移除留置导管的任何情况，而不是完成预定的抗菌治疗过程。

结果

该研究包括每组 50 名患者。PICC组的总随访时间为1376个导管日，对照组为1362个导管日。我们观察到 PICC 组中 ELUCR 的发生率显着降低（每 100 导管日发生 0.2 对 7.7 事件；P  < 0.001）。当根据每种类型导管留置导管的持续时间（分为一周的间隔）分析 ELUCR 的发生率时，两组之间的差异也很显着（治疗的前三周P 值≤ 0.001）。在 IV 治疗的第二周，PICC 组中只有 1 名患者 (2.1%) 出现 ELUCR，而对照组中有 19 名患者 (38.8%) ( P  < 0.001)。

结论

由专门的护理团队放置和维护的 PICC 是外周静脉导管或 CVC 的绝佳替代品，可用于短期和长期治疗的抗菌治疗。