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July 1978

Infection Control in Total Parenteral Nutrition

Arch Intern Med. 1978;138(7):1175. doi:10.1001/archinte.1978.03630320103043

To the Editor.—  We have used a simple method to control infection in total parenteral nutrition for more than ten years without a single infection complication in well over 1,000 administrations of hyperalimentation solutions. To each liter of reconstituted solution is added 1 mg of polymyxin B sulfate to prevent Pseudomonas infections, 1 mg of gentamicin sulfate to prevent staphylococcal infections, and 1 mg of amphotericin B to prevent fungal infections. The antibiotics are in a dose that is harmless to the patients, and, when 1,000 consecutive bottles were found to be sterile after administration, we stopped performing cultures on them. Since the antibiotics are placed directly into the bottles, we have found it unnecessary to use filters, which allows for much easier ingress of the fluid. We change the tubing every third day and use standard care of the subclavian insertion site. This simple stratagem has solved TPN infection

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