# Differences in Efficacy between Antibacterial Lock Therapy and the Standard of Care for CVC-Related Infections: A Systematic Review and Meta-Analysis

## TL;DR

This study compares antibacterial lock therapy to standard care for central venous catheter infections and finds that the therapy may help preserve catheters when replacement is not possible.

## Contribution

The study provides a systematic review and meta-analysis showing that antibacterial lock therapy may be more effective than standard care for CVC-related infections.

## Key findings

- Antibacterial lock therapy showed significant microbiological healing compared to standard care (OR 3.78; 95% CI 2.03–7.03).
- The follow-up period ranged from 2 weeks to 3 months, indicating sustained benefits of antibacterial lock therapy.
- The study highlights the need for randomized controlled trials to confirm the findings and improve evidence quality.

## Abstract

Background: Central Venous Catheter (CVC)-related infections cannot always be solved by replacement, due to some vascular anomalies or an emergency status. This comprehensive, evidence-based review aimed to define the efficacy of antibacterial lock therapy (ALT) compared to the standard of care (SoC) in CVC-related infections. Methods: We performed a systematic search in PubMed, Embase, and Google Scholar, looking for randomized controlled trials (RCTs) and cohort or case-control observational studies. The eligible studies considered the subjects with a diagnosis of CVC-related infections treated with antibacterial lock therapy (ALT) compared to the standard of care (SoC). Results: Among 609 records at the end of the selection process, five articles, referring to observational studies, were included in this systematic review. In pooled analyses, including a total of 276 individuals, microbiological healing (OR 3.78; 95% CI; 2.03–7.03) showed significant differences between ALT and the SoC, with a follow-up varying from 2 weeks to 3 months. Conclusions: Our results suggested that ALT could improve the preservation of CVCs and could be considered when their replacement is not possible as a result of vascular problems. However, only observational studies were included and RCTs are needed to confirm these findings and to increase the level of evidence.