Rifampicin-impregnated central venous catheters: a meta-analysis of randomized controlled trials

Background: The use of antimicrobial-impregnated central venous catheters (CVCs) for the prevention of CVC microbial colonization and catheter-related bloodstream infection (CRBSI) remains controversial. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) evaluating CRBSI and colonization of CVCs impregnated with rifampicin-based antimicrobial combinations. Our main analy-sis compared the occurrence of CRBSI with rifampicin/minocycline-impregnated CVCs with that of non-rifampicin-impregnated CVCs. The PubMed and Cochrane Central Register of Controlled Trials databases were searched (until October 2006). Results: Eight RCTs were included in the analysis. The main analysis (seven RCTs) demonstrated that rifampicin/minocycline-impregnated CVCs were associated with fewer CRBSIs compared with cath-eters not impregnated with rifampicin/minocycline (OR 0.23, 95 % CI 0.14–0.40). The same was true regarding colonization (OR 0.46, 95 % CI 0.31–0.69). Further analysis, comparing rifampicin-based CVCs with non-rifampicin-impregnated CVCs, demonstrated superiority of rifampicin-based CVCs in reducing colonization (OR 0.38, 95 % CI 0.24–0.62) and CRBSI (OR 0.24, 95 % CI 0.14–0.40). Similar results, suggesting superiority of rifampicin/minocycline-impregnated CVCs, were noted in a subgrou