Adding Taurolidine to Heparin Cuts Risk for Catheter-Related Bloodstream Infections

A taurolidine/heparin lock solution carries a lower risk for catheter-related bloodstream infections (CRBSIs) compared with heparin only in patients receiving hemodialysis via a central venous catheter, investigators report.

Taurolidine is an antibacterial and antifungal agent with a mechanism of action that is less prone to development of antimicrobial resistance, Anil K. Agarwal, MD, of the University of California, San Francisco, and colleagues explained. Heparin does not have any antimicrobial properties, but it helps prevent thrombosis.

In the double-blind, phase 3 LOCK IT-100 trial (ClinicalTrials.gov Identifier: NCT02651428), the investigators randomly assigned 397 patients from 70 US sites to taurolidine (13.5 mg/mL) with heparin (1000 units/mL) and 398 patients to heparin only instilled into central venous catheters after dialysis sessions.

CRBSIs occurred in 9 patients (2%) in the taurolidine/heparin group compared with 32 patients (8%) in the standard of care heparin group. Infection events occurred in 0.13 vs 0.46 per 1000 catheter-days, respectively. Patients receiving taurolidine/heparin had a significant 71% reduced risk for CRBSIs, the investigators reported in the Clinical Journal of the American Society of Nephrology.

Rates of catheter removal (for any reason) and loss of catheter patency were comparable between groups.

Treatment-emergent adverse events occurred in 79% of both groups, and most were considered mild to moderate in severity. The death rate was 5% for both groups.

“These findings support the use of taurolidine/heparin in hemodialysis patients to reduce risk of CRSBIs, which are associated with very significant clinical, economic, and quality of life burdens in this vulnerable patient population,” Dr Agarwal’s team concluded.

Disclosure: This research was supported by CorMedix, Inc. Please see the original reference for a full list of disclosures.

This article originally appeared on Renal and Urology News