Antibiotic Lock Therapy

NB: Always use in combination with systemic antibiotics.

NB: Various concentrations have been studied. Further study is required to establish standard effective concentrations.

Recommended concentrations based on available literature:

• Gram positive - cefazolin: 10mg/mL, vancomycin: 5-10mg/mL
• Gram negative - gentamicin: 5-10mg/mL, amikacin: 10mg/mL, ciprofloxacin: 5-10mg/mL

Mix antibiotic with normal saline or 50-100 units of heparin (if compatible) to 2-5mL luminal volume (volume should be printed on outside of line; if not, contact manufacturer). Fill catheter lumen when not in use (e.g. 12h period overnight). Remove solution before infusion of next IV medication or solution.

NB: Antibiotic lock therapy to prevent CRBSI is not generally recommended unless multiple episodes of CRBSI despite optimal adherence to aseptic technique [Clin Infect Dis 2011;52:e1-32].