Antimicrobial/antithrombotic catheter lock solution

Class

Antimicrobial/antithrombotic catheter lock solution (taurolidine + heparin, with citrate) -- taurolidine non-specifically denatures bacterial/fungal cell walls, heparin provides local anticoagulation

Pathway

Prevention of catheter-related bloodstream infection and catheter thrombosis in hemodialysis catheters

Notes

original target text: Antimicrobial/antithrombotic catheter lock solution (taurolidine + heparin, with citrate) -- taurolidine non-specifically denatures bacterial/fungal cell walls, heparin provides local anticoagulation

This mechanism describes a catheter lock solution, a small volume of liquid instilled into the lumen of an indwelling catheter (such as a hemodialysis catheter) between uses of use, rather than infused into the bloodstream. Its purpose is to sit within the catheter and prevent the two most common problems associated with long-term venous access: infection and clot formation. The solution combines taurolidine, an agent that non-specifically denatures the cell walls and membranes of bacteria and fungi, with heparin, which produces local anticoagulation, and citrate, which also chelates calcium to limit clotting and contributes additional antimicrobial activity. Combining an antimicrobial with an antithrombotic addresses the reality that catheter surfaces are prone to both microbial colonization, often through biofilm formation, and fibrin or clot deposition, and that these two problems can worsen each other, since clot and biofilm both provide surfaces for further buildup. This mechanism is broadly relevant wherever patients depend on long-term central venous catheters, most notably in hemodialysis, where repeated catheter access over months or years creates sustained risk of catheter-related bloodstream infection and catheter thrombosis, both of which can require catheter removal, hospitalization, or interruption of dialysis treatment.