Power PICC with antibiotics

cardiacRN2006, ADN, RN · May 19, 2008

I'm not a picc nurse either. But do you mean abx within the picc?

What if the pt is allergic to the abx? Or how does it deal with incompatabilites of other meds/abx?

IndyRick · May 19, 2008

I by abx in, I mean they are treated with a coating of minocycline and rifampin. I don't know if there are allergy issues or compatibility issues with these antibiotics. I'll have to check that out. Thanks.

iluvivt, BSN, RN · May 20, 2008

When PICC catheters are skillfully and thoughtfully placed and maintained they indeed have an extremely low infection rate. In certain patient populations they might be of benefit (ie. immunocompromised pts ,pts with comorbitities, etc). I have seen these types of catheters before and I have been interested in these types of catheters for those lines that have a higher infection rate such as non-tunneled dialysis catheters and short -term percutaneousely placed CVCs. Other products I have seen release the antimicrobials for only a limited amount of time and many many of our pts have thier CVCs for many months. By the way there should be no concern with compatability issues since the catheter is impregnated with the antimicrobials usually at the catheter skin junction and do not mix with the infusate. The power injection feature is just that a feature that allows practitioners the added feature of power injection. The main reason for placing the PICC in the first place still exists (ie, abx, TPN, chemo)

PICC ACE · May 22, 2008

Indy-

Sounds like an interesting combination. The trend for PICCs is definitely toward power injectable capabilities and it probably won't be long before all PICCs placed are power injectable. Antiseptic or antibiotic coated or impregnated PICC's such as Cook's Spectrum have not been as widely embraced. True,there are studies that have shown a decrease in CRBSI's in the studies published. However the major ones (such as Maki,1997 and Darouiche,1999) are getting old and these are from the era before the CDC guidelines and the big push to implement the IHI bundle with the maximun barriers and so one. The big concern used to be insertion site asepsis and that is just as easily achieved with CHG prep at insertion time and during dressing changes as well as using a CHG- or silver-impregnated disk to keep down the counts at the site after insertion. I can't remember the last time I saw a PICC insertion site that was infected and caused a CRBSI.

The interest these days is on the biofilm that develops inside the catheter and that is the source of far more problems. Bacteria get onto the injections caps and on the connections to the catheter and set up shop on the inner lumen of the catheter and from there can cause infections.

So,to answer your questions finally....I would be interested in finding out more,since anything to reduce CRBSI's is a good thing. However,if you want to really get my attention,I'd need more than just a good idea. I would want to see some convincing in vitro proof of the reduction of biofilm on the inner lumen as well as solid objective study data to back it up.

Good luck with your project.

bobnurse · Jun 6, 2008

Our ID docs have asked if a coated PICC Line exists. When we tell them no, they say there should be.

I just saw that there are antibacterial injection caps. I am sure with the increased picc usage, coated cathters will soon be widely available.

With the medicare you cause it you pay for it changes, they will do anything to decrease CRBSI's.