Antibiotic-coated tubes 'could cut child infection rates'

Illustration of a catheter being inserted into a vein in the hand for a general anaesthetic or the injection of various substances Image copyright Wales News Service
Image caption A catheter is inserted into a vein in the hand so that drugs can be administered

Fewer children would develop infections in intensive care if the plastic tubes used to deliver drugs straight into their veins were coated in antibiotics, a study in The Lancet suggests.

At present the practice is used only in adults, but researchers say it should be applied to children too.

Their paper is based on a trial of nearly 1,500 children at 14 intensive care units in England.

The researchers said cutting infections would also save the NHS money.

When patients are admitted to intensive care in hospital a tube, called a line or central venous catheter, is inserted into large veins in the body to deliver drugs, food or fluids.

But bacteria are often attracted to these plastic tubes, making them one of the main reasons for infections in the patient's bloodstream.

These infections can lead to damage to the brain and other organs, and cases of septic shock. They can also occur when blood clots form in and around the tube.

In studies on adult patients, coating the catheters both inside and out with low levels of antibiotics or the blood-thinning drug heparin was found to reduce infections by 70-80%.

Image copyright Science Photo Library
Image caption Tubes or catheters used in intensive care can be magnets for bacteria

This study, from the UCL Institute of Child Health, and Great Ormond Street Hospital, is the first to be carried out in children.

It found that only 1% of patients using an antibiotic-coated catheter developed infections in their bloodstream, compared with 4% of patients using a standard tube.

The study called this "a significant decrease" on normal levels of infection in paediatric intensive care units.

Quen Mok, consultant in intensive care at Great Ormond Street Hospital and one of the study authors, said the tubes should now be used on children.

"Bloodstream infections can be dangerous for children who are already very sick.

"They can make conditions worse and even cause death, so ways to reduce the infection risk to our patients in intensive care would be very welcome."

Although the antibiotic-coated catheter was found to reduce infection numbers in children under 16 years old, a catheter coated in a blood-thinning drug showed no signs of cutting infection rates.

And death rates in intensive care were not reduced by the use of antibiotic-coated tubes.

Tubes coated with antibiotic are more expensive than standard tubes but the researchers said adopting them would still prove cost effective because they would result in shorter hospital stays and reduce the costs of treating infections in intensive care.

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