{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:59:51Z","timestamp":1788433191024,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Objectives: This study aims to evaluate the use and efficacy of antibiotic-lock therapy (ALT) in the management of catheter-related bloodstream infections (CRBSIs), focusing on its impact on infection resolution, catheter retention, and clinical outcomes. Methods: Patients aged \u226518 years diagnosed with CRBSIs who had long-term indwelling catheters and for whom catheter replacement posed clinical challenges were enrolled in the retrospective study from January 2019 to December 2024. Participants were divided into two groups based on treatment: Group 1 received intravenous (IV) antibiotics combined with antibiotic-lock therapy (ALT), while Group 2 received IV antibiotics alone. Patient demographics, pathogen distribution, administered antibiotic regimens, duration of treatment, laboratory parameters, clinical outcomes, and mortality rates were evaluated. Results: A total of 54 patients were included, of whom 42.6% were female, and the mean age was 66.3 \u00b1 15.4 years. Group 1 comprised 50% of the study population. The median treatment duration was 14 days. The most common pathogen was Coagulase-negative staphylococci, and 33.3% of CRBSIs were caused by Gram-negative bacteria (GNB). Group 1 demonstrated lower C-reactive protein levels at treatment 48\/72 h of treatment (p = 0.013) and a reduced frequency of catheter revision (p &lt; 0.0001) compared to Group 2. Overall, ALT achieved a success rate of 88.9%, with success rates of 86% for GNB infections and 90% for Gram-positive bacterial infections. Among patients receiving daily ALT, the success rate was 86%, while those receiving the therapy every three days had a success rate of 90%. Conclusions: Antimicrobial lock therapy can be considered a treatment option for managing CRBSIs, particularly in cases where removal of the implantable catheter is not feasible, allowing for salvage.<\/jats:p>","DOI":"10.3390\/antibiotics14050461","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T07:44:58Z","timestamp":1746171898000},"page":"461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Antimicrobial Lock Therapy: A Strategy for Managing Catheter-Related Bacteremia"],"prefix":"10.3390","volume":"14","author":[{"given":"Firdevs","family":"Aksoy","sequence":"first","affiliation":[{"name":"Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4620-6755","authenticated-orcid":false,"given":"Hanife Nur","family":"Karakoc Parlayan","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulter","family":"Oncu Kurutas","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurdal","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1093\/cid\/cir551","article-title":"Effectiveness of antibiotic-lock therapy for long-term catheter-related bacteremia due to Gram-negative bacilli: A prospective observational study","volume":"53","author":"Funalleras","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Alfieri, A., Di Franco, S., Passavanti, M.B., Pace, M.C., Simeon, V., Chiodini, P., Leone, S., and Fiore, M. (2025). Antimicrobial Lock Therapy in Clinical Practice: A Scoping Review. Microorganisms, 13.","DOI":"10.3390\/microorganisms13020406"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1093\/cid\/cis410","article-title":"Agreement in classifying bloodstream infections among multiple reviewers conducting surveillance","volume":"55","author":"Mayer","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s13756-023-01338-5","article-title":"Microbiological trends and mortality risk factors of central line-associated bloodstream infections in an academic medical center 2015\u20132020","volume":"12","author":"Alwazzeh","year":"2023","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_5","first-page":"343","article-title":"Antibiotic lock therapy: Review of technique and logistical challenges","volume":"7","author":"Justo","year":"2014","journal-title":"Infect. Drug Resist."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/QCO.0b013e32830634d8","article-title":"The role of chelators in preventing biofilm formation and catheter-related bloodstream infections","volume":"21","author":"Raad","year":"2008","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1093\/jac\/dkg179","article-title":"Stability and in vitro efficacy of antibiotic-heparin lock solutions potentially useful for treatment of central venous catheter-related sepsis","volume":"51","author":"Droste","year":"2003","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1177\/039139880903200918","article-title":"Role of antibiotic lock therapy for the treatment of catheter-related bloodstream infections","volume":"32","year":"2009","journal-title":"Int. J. Artif. Organs"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1586\/14787210.5.4.639","article-title":"Antibiotic-lock therapy for long-term catheter-related bacteremia: A review of the current evidence","volume":"5","author":"Korbila","year":"2007","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e162","DOI":"10.1093\/cid\/cir257","article-title":"Guidelines for the prevention of intravascular catheter-related infections","volume":"52","author":"Alexander","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1086\/599376","article-title":"Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America","volume":"49","author":"Mermel","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bouhrour, n., Nibbering, P.H., and Bendali, F. (2024). Medical Device-Associated Biofilm Infections and Multidrug-Resistant Pathogens. Pathogens, 13.","DOI":"10.3390\/pathogens13050393"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1093\/jac\/dkl318","article-title":"Treatment of long-term intravascular catheter-related bacteraemia with antibiotic-lock therapy","volume":"58","author":"Grill","year":"2006","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1093\/jac\/dkh488","article-title":"Treatment of long-term intravascular catheter-related bacteraemia with antibiotic lock: Randomized, placebo-controlled trial","volume":"55","author":"Rijnders","year":"2005","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1179\/joc.2003.15.2.152","article-title":"Antibiotic lock-technique for the treatment of catheter-related bloodstream infections","volume":"15","author":"Viale","year":"2003","journal-title":"J. Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1159\/000331262","article-title":"Anti-infective locks for treatment of central line-associated bloodstream infection: A systematic review and meta-analysis","volume":"34","author":"Silva","year":"2011","journal-title":"Am. J. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/IPC.0b013e31820a5443","article-title":"Antimicrobial lock therapy as an adjunct to management of catheter-related bacteremia: A community hospital experience","volume":"19","author":"Tejwani","year":"2011","journal-title":"Infect. Dis. Clin. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1046\/j.1469-0691.2001.00053.x","article-title":"Coagulase-negative staphylococci as a cause of infections related to intravascular prosthetic devices: Limitations of present therapy","volume":"7","author":"Schulin","year":"2001","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e0126422","DOI":"10.1128\/aac.01264-22","article-title":"In Vivo Effectiveness of Several Antimicrobial Locks to Eradicate Intravascular Catheter Coagulase-Negative Staphylococci Biofilms","volume":"67","author":"Oteiza","year":"2023","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Blanco-Di Matteo, A., Garcia-Fernandez, N., Aguinaga P\u00e9rez, A., Carmona-Torre, F., Oteiza, A.C., Leiva, J., and Del Pozo, J.L. (2022). Pre-Emptive Antimicrobial Locks Decrease Long-Term Catheter-Related Bloodstream Infections in Hemodialysis Patients. Antibiotics, 11.","DOI":"10.3390\/antibiotics11121692"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1053\/j.ajkd.2007.04.014","article-title":"Treatment of dialysis catheter-related Staphylococcus aureus bacteremia with an antibiotic lock: A quality improvement report","volume":"50","author":"Maya","year":"2007","journal-title":"Am. J. Kidney Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e00569-18","DOI":"10.1128\/AAC.00569-18","article-title":"Role of Lock Therapy for Long-Term Catheter-Related Infections by Multidrug-Resistant Bacteria","volume":"62","author":"Freire","year":"2018","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.1001\/jama.2020.6348","article-title":"Effect of C-Reactive Protein-Guided Antibiotic Treatment Duration, 7-Day Treatment, or 14-Day Treatment on 30-Day Clinical Failure Rate in Patients with Uncomplicated Gram-Negative Bacteremia: A Randomized Clinical Trial","volume":"323","author":"Albrich","year":"2020","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Dias, R.F., de Paula, A.C.R.B., Hasparyk, U.G., de Oliveira Rabelo Bassalo Coutinho, M., Alderete, J.R.A., Kanjongo, J.C., Silva, R.A.M., Guimar\u00e3es, N.S., Sim\u00f5es e Silva, A.C., and Nobre, V. (2023). Use of C-reactive protein to guide the antibiotic therapy in hospitalized patients: A systematic review and meta-analysis. BMC Infect. 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