The clinical effectiveness of central venous catheters treated with anti-infective agents in preventing catheter-related bloodstream infections: a systematic review*

Hounsome, Juliet C. ORCID: https://orcid.org/0000-0002-2026-3778, Dwan, Kerry M., Smith, Godfrey W., Gamble, Carrol L., Boland, Angela, Walley, Tom J. and Dickson, Rumona C. 2009. The clinical effectiveness of central venous catheters treated with anti-infective agents in preventing catheter-related bloodstream infections: a systematic review*. Critical Care Medicine 37 (2) , pp. 702-712. 10.1097/ccm.0b013e3181958915

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Abstract

Objectives: To assess the clinical effectiveness of central venous catheters (CVCs) treated with anti-infective agents (AI-CVCs) in preventing catheter-related bloodstream infections (CRBSI). Data Sources: MEDLINE (OVID), EMBASE, SCI//Web of Science, SCI/ISI Proceedings, and the Cochrane Library. Study Selection: A systematic review of the literature was conducted using internationally recognized methodology. All included articles were reports of randomized controlled trials comparing the clinical effectiveness of CVCs treated with AI-CVCs with either standard CVCs or another anti-infective treated catheter. Articles requiring in-house preparation of catheters or that only reported interim data were excluded. Data Extraction: Data extraction was carried out independently and crosschecked by two reviewers using a pretested data extraction form. Data Synthesis: Meta-analyses were conducted to assess the effectiveness of AI-CVCs in preventing CRBSI, compared with standard CVCs. Results are presented in forest plots with 95% confidence intervals. Results: Thirty-eight randomized controlled trials met the inclusion criteria. Methodologic quality was generally poor. Meta-analyses of data from 27 trials assessing CRBSI showed a strong treatment effect in favor of AI-CVCs (odds ratio 0.49 (95% confidence interval 0.37–0.64) fixed effects, test for heterogeneity, chi-square = 28.78, df = 26, p = 0.321, I2 = 9.7). Results subgrouped by the different types of anti-infective treatments generally demonstrated treatment effects favoring the treated catheters. Sensitivity analyses investigating the effects of methodologic differences showed no differences to the overall conclusions of the primary analysis. Conclusion: AI-CVCs appear to be effective in reducing CRBSI compared with standard CVCs. However, it is important to establish whether this effect remains in settings where infection-prevention bundles of care are established as routine practice. This review does not address this question and further research is required.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Healthcare Sciences Schools > Medicine
Publisher:	Society of Critical Care Medicine
ISSN:	0090-3493
Last Modified:	29 Apr 2026 22:49
URI:	https://orca.cardiff.ac.uk/id/eprint/177784

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