Antibiotic Guide for IV Line infections

This page was downloaded with the free trial version of Inspyder Web2Disk.
To remove this message, please purchase the full version from our website.
Inspyder Website

Central line infections

Exit site infection (without sepsis)

Signs:

Pain around exit site
Purulent discharge
Erythema / Induration around exit site

Take samples:

Blood culture through the line
Peripheral blood cultures
Swab of exit site

For temporary central lines

Remove line
Vancomycin IV 1g bd (or od if >65 years) (Monitor blood levels; adjust dose if poor renal function
Change to flucloxacillin if methicillin sensitive S.aureus is isolated.
If blood cultures are negative at 48hrs an oral antibiotic could be given after discussion with microbiology

Notes

Line-associated bacteraemia due to Staph.aureus should be treated with a minimum of 14 days antibiotic therapy after line removal.
Central-line associated bacteraemia due to Staph.epidermidis may respond to antibiotics without line removal, but relapse is common.

Central Line-associated Sepsis

Take samples:

Blood culture through the line
Peripheral blood cultures

Remove line if possible
Vancomycin IV 1g bd (or od if >65 years) (Monitor blood levels; adjust if poor renal function)
If the patient has severe sepsis or blood pressure fails to respond to initial fluid bolus: Gentamicin IV 5mg/kg as a single dose (max 500mg) Monitor blood levels.
Review antibiotic choice with culture results
Change to flucloxacillin IV 1-2g qds if methicillin sensitive Staphylococcus aureus is isolated.

Notes

Line-associated bacteraemia due to Staph.aureus should be treated with a minimum of 14 days antibiotic therapy after line removal.
If the line is not removed then Staph.aureus bacteraemia is likely to recur with associated high risk of morbidity and mortality.
Central-line associated bacteraemia due to Staph.epidermidis may respond to antibiotics without line removal, but relapse is common.

Back to main Line infections page.

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.