Empiric therapy in non-critically ill hemodialysis patients with suspected central line-associated bloodstream infections Central line-associated bloodstream infections, empiric treatment, mortality
Conditions
Interventions
Vancomycin
- Loading dose: 20-30 mg/kg (maximum 3 gm) infused intravenously at rate of 10-15 mg/min
- Maintenance dose 15-20 mg/kg then adjust by vancomycin trough level (pre-hemodialysis)
Piperacill
Active Comparator Drug,Active Comparator Drug
Vancomycin plus piperacillin-tazobactam,Vancomycin plus meropenem
Sponsors
Faculty of medicine, Chiang Mai University
Eligibility
Sex/Gender
All
Age
20 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age 20 years old or more, 2. Clinically suspected CLABSI and aim to empirical treatment as CLABSI decided by physician, 3. Hemodialysis patients who had hemodialysis catheter at any sites (both tunneled and non-tunneled catheter, both Long term and short-term catheter), 4. Patients provide informed consent
Exclusion criteria
Exclusion criteria: 1. Critically ill patients (NEWS score 7 or more), 2. Admission to critical care unit, 3. Severe allergy to antimicrobial regimen, 4. Had prior culture result within 6 months with pathogens where study drugs cannot be used e.g. VRE, CRE, ESBL-producing organisms, MDR-A. baumannii, MDR P. aeruginosa, 5. Exit-site infection, tunnel infection without suspected CLABSI, 6. Refuse to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Clinical response 7 days Clinical response define as resolution of sign and symptom of infection, eg. BT less than 37.8c, sterilization of blood culture within 7 days of treatment | — |
Secondary
| Measure | Time frame |
|---|---|
| N/A N/A N/A | — |
Countries
Thailand
Contacts
Public ContactWorawut Worawutwittaya
Faculty of medicine, Chiang Mai University
Outcome results
None listed