Antibiotic Therapy of Catheter Infections in Patients Receiving Home Parenteral Nutrition

Sarah J. Miller, Roland Dickerson, Amy A. Graziani, Esther A. Muscari, James L. Mullen

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Fifty-eight episodes of catheter-related sepsis in 21 patients receiving home parenteral nutrition were retrospectively studied. Of 81 organisms isolated from the blood, 59% were Gram-positive cocci, 25% were Gram-negative bacilli, and 16% were yeast. Attempts to treat bacterial infections at home with antibiotic therapy while the catheter remained in place were made; fungal isolation resulted in immediate hospitalization and catheter removal. Gram-negative infections more often resulted in eventual hospitalization (92%) and catheter removal (50%) than Gram-positive infections (57% hospitalization and 23% catheter removal). Empiric therapy with 1 g of cefazolin intravenously every 12 hr was successful in only 33% of episodes caused by coagulase-negative staphylococci, whereas vancomycin was successful in 62%. Sensitivity testing was not a reliable guide for antibiotic choice for treatment of these infections. Cefazolin, 1 g, intravenously every 12 hr was successful in only 25% of Gram-negative episodes treated empirically with this regimen. We conclude that our home parenteral nutrition patients should be hospitalized for a few days upon presentation with a catheter infection for clinical evaluation and aggressive antibiotic therapy. Vancomycin is the preferred drug for treatment of catheter-related infections caused by coagulase-negative staphylococcus.

Original languageEnglish (US)
Pages (from-to)143-147
Number of pages5
JournalJournal of Parenteral and Enteral Nutrition
Volume14
Issue number2
DOIs
StatePublished - Mar 1 1990
Externally publishedYes

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Home Parenteral Nutrition
Catheters
Anti-Bacterial Agents
Infection
Cefazolin
Hospitalization
Coagulase
Vancomycin
Staphylococcus
Therapeutics
Catheter-Related Infections
Gram-Positive Cocci
Bacterial Infections
Bacillus
Sepsis
Yeasts
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Antibiotic Therapy of Catheter Infections in Patients Receiving Home Parenteral Nutrition. / Miller, Sarah J.; Dickerson, Roland; Graziani, Amy A.; Muscari, Esther A.; Mullen, James L.

In: Journal of Parenteral and Enteral Nutrition, Vol. 14, No. 2, 01.03.1990, p. 143-147.

Research output: Contribution to journalArticle

Miller, Sarah J. ; Dickerson, Roland ; Graziani, Amy A. ; Muscari, Esther A. ; Mullen, James L. / Antibiotic Therapy of Catheter Infections in Patients Receiving Home Parenteral Nutrition. In: Journal of Parenteral and Enteral Nutrition. 1990 ; Vol. 14, No. 2. pp. 143-147.
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