Minocycline/Rifampin Catheters Shown To Reduce Microbial Resistance

Main Category: MRSA / Drug Resistance
Also Included In: Medical Devices
Article Date: 29 Apr 2008 - 2:00 PDT

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In a study that confirms the critical role antibiotic-impregnated catheters can play to combat the significant worldwide death toll from catheter-related bloodstream infections (CRBSIs), a researcher from a world-renowned medical center has presented clinical evidence that these devices, in fact, reduce the risk of bacteremia and also the likelihood that bacteria could become resistant to the antibiotics used to prevent their colonization. Previously, some medical researchers had expressed concern that the use of these devices could promote antimicrobial resistance.

On April 8, 2008 at the Society for Healthcare Epidemiology of America's (SHEA) 18th Annual Scientific Conference, Issam I. Raad, M.D., an infectious disease physician at The University of Texas M. D. Anderson Cancer Center, presented data demonstrating that after seven years of extensive use of a central venous catheter impregnated with minocycline and rifampin the rate of microbial resistance to minocycline and rifampin actually decreased after use of these catheters.

"This is a major step forward in the science of eliminating CRBSIs, which are responsible for 250 deaths daily in the United States alone," said Charles McIntosh, M.D., chief medical science and technology officer for Cook Group, which manufactures the advanced minocycline/rifampin catheter. "Not only does the medical community now have clinical evidence that catheters impregnated with minocycline and rifampin are 12 times less likely to result in a bloodstream infection than catheters coated with antiseptic or invasive agents, Dr. Raad now has proven that this combination of drugs actually reduces the risk of bacteria developing antibiotic resistance to the drugs used in the minocycline and rifampin impregnated catheters."

In his presentation, "Process & Technology: Complimentary, Not Mutually Exclusive," Dr. Raad noted that after more than 500,000 catheter-days using the antibiotic-impregnated catheter, the rate of resistance to tetracylines and rifampin dramatically decreased. The data demonstrated that the percentage of MRSA resistance to tetracycline decreased from 12 to 7 percent and MRSA resistance to rifampin decreased from 12 to 4 percent (P < 0.01).

"These significant findings disprove the commonly held belief that antimicrobial impregnated devices can raise the rates of antibiotic resistance in patients," said Dr. Raad. "Although both theoretical reasoning and in vitro data pointed to a very low likelihood of developing antimicrobial resistance while using antimicrobial impregnated catheters, the magnitude of resistance, or in this instance lack thereof, can be most accurately assessed by relying on clinical findings from studies of both short-term and long-term vascular catheters."

These results indicate evidence-based guidelines for the prevention of CRBSIs, a common nosocomial infection that develops when bacteria enter the blood stream through a central venous catheter. Conventional catheters that are not impregnated with minocycline and rifampin can more easily allow bacteria to colonize and spread to the patient's blood stream. Catheters using the latest technology that are impregnated with the antibiotics minocycline and rifampin, which act synergistically to provide broad-spectrum activity against gram positive and gram negative organisms, can reduce CRBSI rates.

Dr. Raad is the co-inventor of the synergistic pairing of the antibiotics minocycline and rifampin that are impregnated within the catheter material of the Cook Spectrum® catheter. His institution receives a royalty payment based upon Cook's license to use this patented technology.

Cook Medical