The increasing number of patients with long-term central venous catheters is associated with increasing frequency of their potential complications. One of the most severe complications is represented by catheter related sepsis.
This article describes etiology, diagnostic process and therapy of catheter related sepses. There are two main therapeutic options - extraction of catheter and systemic antibiotic treatment or systemic antibiotic treatment in combination with application of bactericide solution into catheter lumen - antibiotic lock (solution containing a high concentration of antibiotic with heparin) or ethanol lock (mostly 70% ethanol solution).
Indications, contraindications, technical aspects of application and possible complications are described. It is concluded that combined therapy including systemic antibiotics and ethanol lock is safe, relatively simple and very effective treatment in therapy of catheter sepsis with the same or higher efficacy then in antibiotic lock treatment.
Recently published data warrants the application of this treatment in the lowest age groups of patients in pediatrics and suggest its possible usage not only as a treatment, but also in the field of prevention of catheter sepses in patients with long-term catheters and with high risk of septic states.