Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Antibiotic Lock Therapy

Used when catheter salvage is the goal

Consult ID and Pharmacy if lock therapy is being considered.

Notes

Indicated for patients with a CRBSI involving long-term catheters with no signs of exit site or tunnel infection.

Antibiotic lock should be used in conjunction with systemic antimicrobial therapy together for 7-14 days.

Antibiotic lock solutions should not dwell for > 48H

  • For femoral catheters, the antibiotic lock solution should be reinstalled Q24H

  • For patients undergoing hemodialysis, the lock solution can be renewed after every dialysis session.

Antibiotic lock therapy should not be used for CRBSI due to S. aureus, Pseudomonas aeruginosa, multidrug resistant Gram negative bacilli or Candida species.

For patients with multiple positive catheter-drawn blood cultures that grow coagulase-negative staphylococci or gram-negative bacilli and concurrent negative peripheral blood cultures, antibiotic lock therapy can be given without systemic therapy for 10-14 days.

For vancomycin, the concentration should be at least 1000 times higher than the MIC of the microorganism involved.