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March 11, 1996

Catheter-Related Infections-Reply

Author Affiliations

Boston, Mass

Arch Intern Med. 1996;156(5):584. doi:10.1001/archinte.1996.00440050144017

Buchman's comments regarding the need for removal of long-term central venous access catheters in the treatment of catheter-associated S aureus bacteremia are appreciated. This question has not been formally adressed in a prospective, randomized trial. In our article, we acknowledge the limitations of our retrospective review involving relatively small numbers of patients in each category. However, S aureus catheter-associated bacteremia is associated with a wide range of complications (eg, metastatic infection, relapse, and death), and our data in combination with the findings of other studies1,2suggest that these complications may be higher in patients whose catheters are left in place. Even a small excess mortality rate should not be acceptable in these patients. Therefore, in the absence of controlled trials indicating equivalency of outcomes, we support a general recommendation for prompt removal of temporary and long-term catheters in the setting of S aureus catheter-related bacteremia. This recommendation has been

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