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Antibiotic lock therapy in paediatric patients: primum non nocere.
  1. Nerea Báez-Gutiérrez,
  2. Héctor Rodríguez-Ramallo,
  3. Concepción Alvarez Del Vayo
  1. Hospital Pharmacy Department, Virgen del Rocio University Hospital, Sevilla, Spain
  1. Correspondence to Héctor Rodríguez-Ramallo, Virgen del Rocio University Hospital, Sevilla 41013, Andalucía, Spain; hector.rodriguez.sspa{at}

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Antimicrobial lock therapy (ALT) is recommended by the Infectious Diseases Society of America (IDSA) as the standard of care for certain infections associated with central venous access devices (CVADs) since 2009.1

ALT consists of instilling high concentrations of antimicrobials, usually 1000 times the minimum inhibitory concentration, into the lumen of an infected catheter, where the solution remains for a specified period.

Moreover, in ALT, a substance with anticoagulant activity such as heparin can be used together with antibiotics to maintain the patency of the catheter. It is also believed that it improves the penetration of antibiotics into the microbial biofilm by interfering with fibrin formation in the catheter …

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  • Contributors NBG and HRR designed and drafted the manuscript; CADV reviewed the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.