Cochrane · systematic review · CD013554
Interventions for treating catheter‐related bloodstream infections in people receiving maintenance haemodialysis
Almeida, BM, Moreno, DH, Vasconcelos, V, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
17
current version
GRADE rated
5
No studies
12
Included studies
NR
No studies 12 · 70.6%Ungraded 0 · 0%Very low 5 · 29.4%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator versus systemic antibiotics plus antibiotic lock solutions plus heparin
Population: patients on maintenance HD with CRBSI
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: short‐term success Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator vs systemic antibiotics plus antibiotic lock solutions plus heparin | RR 0.92 [0.74, 1.15] | 18 participants | Very low Downgraded: risk of bias, inconsistency |
Cure: long‐term success Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator vs systemic antibiotics plus antibiotic lock solutions plus heparin | RR 64 [0.38, 1.06] | 18 participants | Very low Downgraded: risk of bias, inconsistency |
Cure: infection‐free survival Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator vs systemic antibiotics plus antibiotic lock solutions plus heparin | no estimate extracted | 18 participants | Very low Downgraded: risk of bias, inconsistency |
Stenosis or thrombosis of vascular access site after catheter removal Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator vs systemic antibiotics plus antibiotic lock solutions plus heparin | no estimate extracted | NR | No studies |
Death Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator vs systemic antibiotics plus antibiotic lock solutions plus heparin | no estimate extracted | NR | No studies |
Development of antibiotic resistance Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator vs systemic antibiotics plus antibiotic lock solutions plus heparin | no estimate extracted | NR | No studies |
Adverse effects Systemic antibiotics plus antibiotic lock solutions plus tissue plasminogen activator vs systemic antibiotics plus antibiotic lock solutions plus heparin | no estimate extracted | NR | No studies |
Systemic antibiotics alone versus systematic antibiotics plus antibiotic lock solution
Population: patients on maintenance HD with CRBSI
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: successful eradication of the infection Systemic antibiotics alone vs systematic antibiotics plus antibiotic lock solution | RR 1.61 [1.16, 2.23] | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Stenosis or thrombosis of vascular access site after catheter removal Systemic antibiotics alone vs systematic antibiotics plus antibiotic lock solution | no estimate extracted | NR | No studies |
Death Systemic antibiotics alone vs systematic antibiotics plus antibiotic lock solution | no estimate extracted | NR | No studies |
Development of antibiotic resistance Systemic antibiotics alone vs systematic antibiotics plus antibiotic lock solution | no estimate extracted | NR | No studies |
Adverse effects Systemic antibiotics alone vs systematic antibiotics plus antibiotic lock solution | no estimate extracted | NR | No studies |
Catheter guidewire exchange versus catheter removal and replacement
Population: patients on maintenance HD with CRBSI
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cure: infection‐free survival Catheter guidewire exchange vs catheter removal and replacement | HR 0.881 [0.43, 1.79] | 1 study · 678 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Stenosis or thrombosis of vascular access site after catheter removal Catheter guidewire exchange vs catheter removal and replacement | no estimate extracted | NR | No studies |
Death Catheter guidewire exchange vs catheter removal and replacement | no estimate extracted | NR | No studies |
Development of antibiotic resistance Catheter guidewire exchange vs catheter removal and replacement | no estimate extracted | NR | No studies |
Adverse effects Catheter guidewire exchange vs catheter removal and replacement | no estimate extracted | NR | No studies |