Joan Webster 1,2, Nicole Marsh 1,2, Emily Larsen 1,2, Md Abu Choudhury 2,3, Nicole Gavin 1,2, Catriona Booker 1, David Paterson 3
1 Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
2 Menzies Health Institute, Griffith University, Nathan, QLD, Australia
3 University of Queensland, Herston, QLD, Australia
Chlorhexidine impregnated discs (Biopatch™) have been recommended to prevent central line associated blood stream infection (CLABSI). A new product Kendall™ AMD Foam Disc® is being marketed for the same purpose but the product is less expensive than Biopatch™. These products are yet to be tested in head to head comparisons with any other antimicrobial disc. The aims of this study were to test the safety of Kendall™ AMD Foam Disc® and to assess the feasibility of conducting a suitably powered trial comparing the effectiveness of the products to prevent CLABSI.
We conducted a single-centre, pilot study where non-ICU patients requiring a PICC line were randomly allocated to either a Biopatch™ or Kendall™ group. The safety outcome was any disc-related adverse event and the feasibility outcomes were 1) ≥ 80% of eligible participants will agree to enrol; 2) ≥ 95% of participants will receive prescribed intervention; 3) < 5% of patients will be lost to follow up. We also documented any incidence of CLABSI and measured skin colonisation under the discs.
92 patients were recruited. Five (5.4%) patients refused participation; 14 (15.2%) protocol breaches occurred and no patients were lost to follow-up. Five positive blood cultures were reported (two were likely contaminants, one in each study arm). Of the remaining three cultures, one was in the Biopatch™ and two in the Kendall™ group.
Kendall™ AMD Foam Disc® is safe to use for skin disinfection and feasibility to conduct an adequately powered trial has been established.