From the Guidelines
Augmentin (amoxicillin-clavulanate) is not the first-line treatment for uncomplicated catheter-related infections, and its effectiveness is not clearly established in the provided guidelines. The guidelines for the management of intravascular catheter-related infections, as outlined in the studies 1, focus on the removal of the catheter, use of antimicrobial lock therapy, and systemic antimicrobial therapy based on the type of catheter and the infecting organism.
When considering treatment options, it's essential to assess the type of catheter, the severity of the infection, and the potential pathogen involved. For example, in cases of uncomplicated catheter-related bloodstream infection (CRBSI) involving long-term catheters due to pathogens other than S. aureus, P. aeruginosa, Bacillus species, Micrococcus species, Propionibacteria, fungi, or mycobacteria, treatment may be attempted without catheter removal, with use of both systemic and antimicrobial lock therapy, as recommended in 1.
Key considerations in managing catheter-related infections include:
- Removing the catheter when there are signs of local infection or clinical signs of sepsis, as recommended in 1
- Using antimicrobial lock therapy for the treatment of catheter-related bacteremia due to certain pathogens, as recommended in 1
- Initiating empirical iv antimicrobial therapy based on clinical clues, the severity of the patient’s acute illness, underlying disease, and the potential pathogen(s) involved, as outlined in 1
- Assessing the need for catheter removal or replacement, as infected foreign bodies often don't respond to antibiotics alone, and keeping the site clean and dry with regular dressing changes.
In terms of specific antibiotic regimens, the guidelines do not explicitly recommend Augmentin (amoxicillin-clavulanate) as a first-line treatment for uncomplicated catheter-related infections. However, the choice of antibiotic should be guided by the suspected or confirmed pathogen, local antimicrobial resistance patterns, and the patient's clinical condition, as well as considerations of morbidity, mortality, and quality of life.
From the Research
Effectiveness of Augmentin in Treating Uncomplicated Catheter-Related Infections
- There is limited direct evidence on the effectiveness of Augmentin (amoxicillin-clavulanate) in treating uncomplicated catheter-related infections 2, 3, 4, 5, 6.
- A study from 1994 found that Staphylococcal infections responded equally well to local cleaning and vancomycin plus rifampin or oral trimethoprim/sulfamethoxazole therapy, but did not mention the use of Augmentin 2.
- Another study from 2011 discussed the prevention and management of central line-associated bloodstream infections, but did not provide information on the use of Augmentin in treating these infections 3.
- A 2019 editorial discussed the use of antibiotic lock therapy, including the potential use of Augmentin, in treating catheter-related bloodstream infections, but noted that the available evidence is scanty and mostly based on small, short-term, observational studies 4.
- A 2019 review discussed the pathophysiology, treatment, and prevention of catheter-associated urinary tract infections, but did not provide information on the use of Augmentin in treating these infections 5.
- A 2004 review discussed the use of Augmentin in treating community-acquired respiratory tract infections, highlighting its broad-spectrum antibacterial activity and favorable pharmacokinetic/pharmacodynamic profile, but did not address its use in treating catheter-related infections 6.