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document
A randomized , controlled trial of the efficacy of a heparin and vancomycin solution in preventing central venous catheter infections in children . OBJECTIVE To determine whether adding vancomycin to central venous catheter ( CVC ) flush solution would significantly reduce the incidence of bacteremia attributable to luminal colonization with vancomycin-susceptible organisms . STUDY DESIGN Fifty-five children with cancer and eight children given total parenteral nutrition by the surgery or nutrition support services were randomly assigned to receive a heparin CVC flush solution ( n = 31 ) or a heparin-vancomycin CVC flush solution ( n = 32 ) . RESULTS During 9158 catheter days , 6.5 % of the patients in the heparin group and 15.6 % of the patients in the heparin-vancomycin group had bacteremia attributable to luminal colonization with vancomycin-susceptible organisms ( p = 0.43 ) . The mean rates of bacteremia attributable to luminal colonization with vancomycin-susceptible organisms were 0.6/1000 catheter days in the heparin group and 1.4/1000 catheter days in the heparin-vancomycin group ( p = 0.25 ) . There was no significant difference between the groups when the time to the first episode of bacteremia attributable to luminal colonization with a vancomycin-susceptible organism was compared by means of Kaplan-Meier survival estimates . Streptococcus viridans infection was not attributable to luminal colonization . CONCLUSION The addition of vancomycin to heparin CVC flush solution did not reduce bacteremia with vancomycin-susceptible organisms . Bacteremia with Streptococcus viridans was not related to the use of a CVC .
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Intervention_Pharmacological
heparin
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Intervention_Pharmacological
vancomycin solution
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Intervention_Pharmacological
vancomycin
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Intervention_Pharmacological
central venous catheter ( CVC ) flush
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Intervention_Pharmacological
heparin CVC flush solution
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Intervention_Pharmacological
heparin-vancomycin CVC flush solution
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Outcome_Other
efficacy
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Outcome_Physical
central venous catheter infections
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Outcome_Physical
mean rates of bacteremia
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Outcome_Physical
time to the first episode of bacteremia
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Outcome_Physical
Streptococcus viridans infection
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Outcome_Physical
bacteremia
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Outcome_Physical
Bacteremia
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Participant_Condition
central venous catheter infections
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Participant_Age
children
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Participant_Sample-size
Fifty-five
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Participant_Age
children
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Participant_Condition
cancer
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Participant_Sample-size
eight
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Participant_Age
children
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Participant_Condition
total parenteral nutrition by the surgery or nutrition support services