Ethanol-lock Therapy Ineffective at Preventing CLABSIs in Pediatric Cancer Patients

The therapy, used to treat and prevent bloodstream infections and related complications in patients who have central venous catheters, has been found to be ineffective in pediatric cancer patients.

Ethanol-lock therapy, used to treat and prevent bloodstream infections and related complications in patients who have central venous catheters, has been found to be ineffective in pediatric cancer patients, according to a new study in The Lancet Infectious Diseases.

Central line placement is necessary for some patients who are undergoing chemotherapy and other continuous intravenous treatment as a way of avoiding multiple needle sticks. Unfortunately, this also opens patients up to the risk of serious infection. According to the US Centers for Disease Control and Prevention (CDC) about 41,000 bloodstream infections occur in hospitalized patients with central lines, each year. Of those who become infected, 1 in 4 will die.

Pediatric cancer patients with central lines face similar odds, with about 1 in 4 at risk of developing a central line-associated bloodstream infection (CLABSI). About one-third of those who develop an infection may end up with multiple infections, persistent infections, or may require additional surgery, despite antibiotic therapy, according to a statement on the Lancet study released by St. Jude Children's Research Hospital, who conducted the research.

For the study, the investigators randomly assigned a total of 94 patients being treated at St. Jude and at the Royal Children's Hospital in Melbourne, Australia into 2 groups of central-line treatment for 6 months. One group received treatment with 70% ethanol solution and the other received treatment with saline solution.

The results revealed that “about 44% of patients in both groups developed new or recurring infections or required surgical replacement of central lines. In addition, 58% of patients in the ethanol group needed blood-thinners to open blocked central lines compared to about 33% in the placebo group,” according to the statement.

In related research discussed in the study, first and corresponding author Joshua Wolf, MBBS, assistant member, St. Jude Department of Infectious Diseases found that, “patients who received ethanol therapy were 2.5-times more likely than patients in the placebo (saline) group to develop catheter blockages that required treatment with blood thinners.”