{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:47:07Z","timestamp":1792162027701,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Central line\u2013associated bloodstream infections (CLABSI) cause substantial morbidity and mortality. Management often requires removing the infected central venous catheter (CVC) and inserting a new one. Effective catheter-salvage strategies are needed.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n An international, multicenter, prospective, randomized superiority trial at 34 centers in the United States, Puerto Rico, and India enrolled patients aged \u226512 years with a long-term central venous catheter (CVC) in place for \u22655 days and CLABSI. Participants were randomized 1:1 to receive systemic antibiotics plus minocycline-EDTA-ethanol lock therapy (MLT) or standard-of-care antibiotic lock therapy (SOC-ALT) for 7 to 14 days. The primary endpoint was median time to catheter failure, defined as clinical failure (death, infection-related catheter removal, worsening symptoms) or microbial failure (persistent\/recurrent infection or new deep-seated infection attributable to the index CLABSI).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n From 2018-2024, 241 patients were randomized; 228 received lock therapy. Catheter retention was higher with MLT than SOC-ALT (57% vs 38%; P = 0.0025). Median time to catheter failure was longer with MLT in both intention-to-treat (not estimable vs 33 days, HR 0.53, P = 0.0006) and modified intention-to-treat populations (not estimable vs 35 days, HR 0.50, P = 0.0005). Clinical catheter failure (13% vs 28%; P = 0.006) and microbiological failure (5% vs 15%; P = 0.012) were lower with MLT. Adverse events, serious adverse events, and mortality were similar between groups, with no drug-related serious adverse events.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n MLT was superior to SOC-ALT in salvaging long-term CVCs in CLABSI and was well tolerated, addressing an unmet need in CLABSI management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/cid\/ciag660","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:55:08Z","timestamp":1791978908000},"source":"Crossref","is-referenced-by-count":0,"title":["Randomized Trial Comparing Minocycline-EDTA-Ethanol Lock to Standard-of-Care Antibiotic Lock for Management of Central Line\u2013Associated Bloodstream Infection"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8097-8452","authenticated-orcid":false,"given":"Anne-Marie","family":"Chaftari","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center , Houston, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4315-5072","authenticated-orcid":false,"given":"Vinay","family":"Rathore","sequence":"additional","affiliation":[{"name":"Department of Nephrology, All India Institute of Medical Sciences-Raipur , Raipur ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Hachem","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center , Houston, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4502-353X","authenticated-orcid":false,"given":"Toan T","family":"Huynh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Critical Care and Acute Care Surgery, Atrium Health , Charlotte, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul P","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Brody School of Medicine, East Carolina University , Greenville, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onix","family":"Cantres-Fonseca","sequence":"additional","affiliation":[{"name":"Advent Health Transplant Institute Orlando , Florida , ; , San Juan ,","place":["USA Puerto Rico"]},{"name":"VA Caribbean Healthcare System , Florida , ; , San Juan ,","place":["USA Puerto Rico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1677-3994","authenticated-orcid":false,"given":"Mayur","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Infectious Diseases, Henry Ford Hospital , Detroit, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Princy N","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, Georgetown University Medical Center , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8946-8272","authenticated-orcid":false,"given":"Mark E","family":"Rupp","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center , Omaha, Nebraska ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8898-7406","authenticated-orcid":false,"given":"Leonard A","family":"Mermel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Warren Alpert Medical School of Brown University , Providence, RI ,","place":["USA"]},{"name":"; Department of Epidemiology & Infection Prevention, Brown University Health , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myron S","family":"Czuczman","sequence":"additional","affiliation":[{"name":"Clinical Operations, Citius Pharmaceuticals , Cranford, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Lader","sequence":"additional","affiliation":[{"name":"Clinical Operations, Citius Pharmaceuticals , Cranford, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issam I","family":"Raad","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center , Houston, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,16]]},"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciag660\/72044998\/ciag660.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciag660\/72044998\/ciag660.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:06:31Z","timestamp":1792159591000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciag660\/8931553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/cid\/ciag660","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"article-number":"ciag660"}}