Antibiotics for preventing early central venous catheter Gram positive infections in people with cancer

Oncology patients require venous access during chemotherapy, therefore central venous catheters (CVCs) are frequently inserted. Chemotherapy duration will often last from six months to two years so a long-term tunnelled central venous catheter (TCVC) is used. Despite standard protocols for insertion and maintenance of these catheters infections do occur. It is therefore necessary to find alternative ways to prevent such infections. This review first focused on randomized controlled trials (RCTs) on administering antibiotics prior to insertion of the catheter. The results show that it is not beneficial to give an antibiotic prior to insertion of the catheter. The second focus of the review was RCTs flushing the newly inserted catheter with a combination of a low dose vancomycin and heparin. The results show that it is beneficial to flush the catheter with the combination of vancomycin and heparin, but only for high-risk patients where this intervention minimizes the risk of introducing microbial resistance.