We Avoid Antibiotic Lock Solutions due to Fear of Antibiotic Resistance

Hemodialysis catheter-related bacteremia (CRB) is the most common complication associated with catheter use in dialysis patients and portends a high morbidity and mortality. Current CDC and KDIGO guidelines recommend treating CRBs with systemic antibiotics in conjunction with catheter replacement, although the latter has limitations. Antibiotic lock solutions (ABLs) are very effective in both prevention and treatment of CRBs in hemodialysis patients and may be a preferred alternative to catheter replacement especially in patients where catheter salvage is a priority. Previous smaller observational studies have raised concerns of a potential increase in antibiotic resistance associated with the widespread use of ABLs. Review of the recent literature does not support this claim.