Evidence map›Paper›PMID 37993679›Full record

Trial reportEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2024

Comparing ethanol lock therapy versus vancomycin lock in a salvation strategy for totally implantable vascular access device infections due to coagulase-negative staphylococci (the ETHALOCK study): a prospective double-blind randomized clinical trial.

Olivier Lesens, Emmanuel Forestier, Elisabeth Botelho-Nevers, Patricia Pavese, Gary David, Bertrand Nougarede, Violaine Corbin, Bruno Pereira, Claire Aumeran, Léo Sauvat

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 2 countries.

Olivier LesensInfectious and Tropical Diseases Department, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana. olivier.lesens@ch-cayenne.fr.ORCID http://orcid.org/0000-0003-4359-0306
Emmanuel ForestierInfectious Disease Department, Metropole Savoie Hospital Center, Chambery, France.
Elisabeth Botelho-NeversInfectious Diseases Department, Saint-Etienne University Hospital Center, Saint-Etienne, France.
Patricia PaveseInfectious Disease Department, Grenoble University Hospital Center, Grenoble, France.
Gary DavidInfectious Disease Department, Villefranche sur Saône Hospital Center, Villefranche sur Saône, France.
Bertrand NougaredeJean Perrin Comprehensive Cancer Center, Clermont-Ferrand, France.
Violaine CorbinInfectious and Tropical Diseases Department, Clermont-Ferrand University Hospital Center, Reference Center for Osteoarticular Infections, Regional Reference Center for Tick-Based Vector Diseases, Genome and Environment Microorganisms Laboratory, Clermont Auvergne University, Clermont-Ferrand, France.
Bruno PereiraClinical Research Direction, Clermont-Ferrand University Hospital Center, Clermont-Ferrand, France.
Claire AumeranInfection Control Department, 3IHP, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France.
Léo SauvatInfection Control Department, 3IHP, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France.
Centre Hospitalier Universitaire de Clermont-Ferrand · FRCentre Hospitalier Métropole Savoie · FRCentre Hospitalier Universitaire de Grenoble · FRCentre Hospitalier Universitaire de Saint-Étienne · FRCentre Jean Perrin · FRLaboratoire de Biologie du Développement de Villefranche-sur-Mer · FRUniversité Clermont Auvergne · FRUniversity of Clermont Auvergne · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesLittle is known about efficacy and safety of ethanol lock therapy (ELT) to treat totally implantable venous access device (TIVAD) infections. The objective of this trial was to evaluate the effectiveness and safety profile of a local treatment with ELT without removal for TIVAD infection due to coagulase-negative staphylococci.

methodsWe performed a prospective, multicenter, double-blind, randomized clinical trial comparing the efficacy of 40% ELT versus vancomycin lock therapy (VLT) in TIVAD infections due to coagulase-negative staphylococci, complicated or not by bloodstream infection.

resultsThirty-one patients were assigned to the ELT group and 30 to the VLT arm. Concomitant bacteremia was present in 41 patients (67.2%). Treatment success was 58.1 % (18 of 31) for the ELT arm and 46.7% (14 of 30) for the VLT arm (p = 0.37). The overall treatment success was 52.5% (32). The risk of treatment failure due to uncontrolled infections, superinfections, and mechanical complications did not differ significantly between participants receiving ELT (13 out of 31 [42%]) and those receiving VLT (16 out of 30 [53%]) with a hazard ratio of 0.70 (p = 0.343; 95% CI [0.34-1.46], Cox model). Catheter malfunctions were significantly more frequent in the ELT arm (11 patients versus 2 in the VLT group, p = 0.01).

conclusionsWe found an overall high rate of treatment failure that did not differ between the ELT arm and the VLT arm. TIVAD removal must be prioritized to prevent complications (uncontrolled infections, superinfections, and catheter malfunctions) except in exceptional situations.

Indexed as

BacteremiaCatheterization, Central VenousCatheter-Related InfectionsCentral Venous CathetersSuperinfectionCoagulaseEthanolHumansProspective StudiesStaphylococcusVancomycinCoagulaseEthanolVancomycinCentral venous catheter infectionCoagulase-negative staphylococciEthanolLock solutionTotally implantable vascular access deviceVancomycin

Identifiers

PMID37993679
OpenAlexW4388924560

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.