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Optimal Frequency of Changing Intravenous Administration Sets: Is It Safe to Prolong Use Beyond 72 Hours?

Issam Raad , MD, Hend A. Hanna , MD, MPH, Abeer Awad , MD, Amin Alrahwan , MD, Carol Bivins , RN, Asma Khan , MD, Deborah Richardson , RN, Jan L. Umphrey , MPH, Estella Whimbey , MD and Georganne Mansour , RN
Infection Control and Hospital Epidemiology
Vol. 22, No. 3 (March 2001), pp. 136-139
DOI: 10.1086/501879
Stable URL: http://www.jstor.org/stable/10.1086/501879
Page Count: 4
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Optimal Frequency of Changing Intravenous Administration Sets: Is It Safe to Prolong Use Beyond 72 Hours?
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Abstract

OBJECTIVE.  To determine the safety and cost‐effectiveness of replacing the intravenous (IV) tubing sets in hospitalized patients at 4‐ to 7‐day intervals instead of every 72 hours. DESIGN.  Prospective, randomized study of infusion‐related contamination associated with changing IV tubing sets within 3 days versus within 4 to 7 days of placement. SETTING.  A tertiary university cancer center. PATIENTS AND METHODS.  Cancer patients requiring IV infusion therapy were randomized to have the IV tubing sets replaced within 3 days (280 patients) or within 4 to 7 days of placement (232 patients). Demographic, microbiological, and infusionrelated data were collected for all participants. The main outcome measures were infusion‐ or catheter‐related contamination or colonization of IV tubing, determined by quantitative cultures of the infusate, and infusion‐ or catheter‐related bloodstream infection (BSI), determined by quantitative culture of the infusate in association with blood cultures in febrile patients. RESULTS.  The two groups were comparable in terms of patient and catheter characteristics and the agents given through the IV tubing. Intent‐to‐treat analysis demonstrated a higher level of tubing colonization in the 4‐ to 7‐day group versus the 3‐day group (median, 145 vs 50 colony‐forming units; P=.02). In addition, there were three episodes of possible infusion‐related BSIs, all of which occurred in the 4‐ to 7‐day group (P=.09). However, when the 84 patients who received total parenteral nutrition, blood transfusions, or interleukin‐2 through the IV tubing were excluded, the two groups had a comparable rate of colonization (0.4% vs 0.5%), with no catheter‐ or infusion‐related BSIs in either group. CONCLUSION.  In patients at low risk for infection from infusion‐ or catheter‐related infection who are not receiving total parenteral nutrition, blood transfusions, or interleukin‐2, delaying the replacement of IV tubing up to 7 days may be safe, as well as cost‐effective.

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