Background and Importance In patients with difficult intravenous access or those who require short-term intravenous drug administration, midline catheters (MLC) can be a safe alternative to peripherally inserted central catheters (PICCs).
Aim and Objectives The objective of this study is to describe outcomes in patients who had a midline placed for the indication of antibiotic therapy.
Material and Methods This cohort study analysed data from hospital registry including patients who had a midline placement for intravenous antibiotic therapy. Patient demographics and clinical data (diagnoses, comorbidities, medications, laboratory values, antibiotic use and duration of infusion therapy), and device variable (placement arm and vein of insertion, catheter gauge, and number of catheter lumens) were abstracted directly from medical records. Data were analysed from June 2021 to September 2022.
Results Sixty-nine patients with MLC were included for analysis, 68% were male and mean age was 70 years (range 28–96). The most common diagnoses were bloodstream infection (46.4%), respiratory tract infections (17.4%) and urinary tract infections (14.5%). The most prescribed antimicrobials were piperacillin-tazobactam (52.2%), ertapenem (19%) and meropenem (11.6%).
In total 69 MLC were placed, totaling 952 catheter-days, with and average midline dwell-time of 14 days (range = 2-43 days; median = 12 days). Total complications were 31.9%, including four (5.8%) ‘leak’, fourteen (20.3%) catheter obstructions, two (2.9%) phlebitis and one (1.45%) thrombosis. In addition, one patient presented a grade I infiltrations (INS Infiltration Scale). There were no confirmed or suspected bloodstream infection.
Conclusion and Relevance In this study, the MLC complication rate was 31.9%. The complications were mostly mechanical (81.8%) and did not require the suspension of the antibiotic therapy or the withdrawal of the catheter.
Conflict of Interest No conflict of interest
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