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Lau EPM, Faber S, Charlesworth C, Morey S, Vekaria S, Filion P, Chakera A, Lee YCG. Topical antibiotics prophylaxis for infections of indwelling pleural/peritoneal catheters (TAP-IPC): A pilot study. Respirology 2024; 29:176-182. [PMID: 37696757 DOI: 10.1111/resp.14595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Indwelling pleural catheter (IPC) and indwelling peritoneal catheter (IPeC) have established roles in the management of malignant pleural and peritoneal effusions but catheter-related infections remain a major concern. Topical mupirocin prophylaxis has been shown to reduce peritoneal dialysis catheter infections. This study aimed to assess the (i) compatibility of IPC with mupirocin and (ii) feasibility, tolerability and compliance of topical mupirocin prophylaxis in patients with an IPC or IPeC. METHODS (i) Three preparations of mupirocin were applied onto segments of IPC thrice weekly and examined with scanning electron microscope (SEM) at different time intervals. (ii) Consecutive patients fitted with IPC or IPeC were given topical mupirocin prophylaxis to apply to the catheter exit-site following every drainage/dressing change (at least twice weekly) and followed up for 6 months. RESULTS (i) No detectable structural catheter damage was found with mupirocin applied for up to 6 months. (ii) Fifty indwelling catheters were inserted in 48 patients for malignant pleural (n = 41) and peritoneal (n = 9) effusions. Median follow-up was 121 [median, IQR 19-181] days. All patients tolerated mupirocin well; one patient reported short-term local tenderness. Compliance was excellent with 95.8% of the 989 scheduled doses delivered. Six patients developed catheter-related pleural (n = 3), concurrent peritoneal/local (n = 1) and skin/tract (n = 2) infections from Streptococcus mitis (with Bacillus species or anaerobes), Staphylococcus aureus, Klebsiella pneumoniae and Pseudomonas aeruginosa. CONCLUSION This first study of long-term prevention of IPC- or IPeC-related infections found topical mupirocin prophylaxis feasible and well tolerated. Its efficacy warrants future randomized studies.
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Affiliation(s)
- Estee P M Lau
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Sam Faber
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Chloe Charlesworth
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Sue Morey
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Sona Vekaria
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- Department of Pharmacy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Pierre Filion
- PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia, Australia
| | - Aron Chakera
- Renal Unit, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Y C Gary Lee
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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Peel AM, Mishra EK. The Psychosocial Impact of Indwelling Pleural Catheters: A Scoping Review. Cureus 2023; 15:e41689. [PMID: 37575731 PMCID: PMC10413413 DOI: 10.7759/cureus.41689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/15/2023] Open
Abstract
We aimed to identify research on the psychosocial impact of Indwelling Pleural Catheters (IPC); report on the extent, range, and nature of studies; and summarize the findings. A secondary aim was to capture reports on patient support needs and/or self-management of IPC. A systematic literature search was undertaken, with evidence synthesis planned if sufficient literature was identified. We searched ten databases available through the United Kingdom National Health Service Knowledge and Library Hub: the British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Excerpta Medica Database (Embase), Exerpta Medica Care (Emcare), E-thesis Online Service (EThOS), Medical Literature Analysis and Retrieval System Online (Medline), National Grey Literature Collection, Psychological Information Database (PsycInfo), and PubMed. We included studies reporting on the psychosocial impact of indwelling pleural catheters or their effect on quality of life (QoL). The latter was limited to those studies using qualitative research methods from which we could identify psychosocial impacts. The evaluation of psychosocial factors was not the primary objective of any identified study, and we found no studies in which quality of life was assessed using qualitative methods. Two studies met the inclusion criteria but only tangentially. While indwelling pleural catheters may improve the quality of life in patients with pulmonary effusion when assessed quantitatively, there is a dearth of research examining their psychosocial impact.
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Affiliation(s)
- Adam M Peel
- Community Research, Norfolk Community Health and Care NHS Trust, Norwich, GBR
- School of Health Sciences, University of East Anglia, Norwich, GBR
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Aujayeb A. A note in indwelling pleural catheter infections. THE CLINICAL RESPIRATORY JOURNAL 2021; 15:244. [PMID: 33113281 DOI: 10.1111/crj.13299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 10/23/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Avinash Aujayeb
- Northumbria HealthCare NHS Foundation Trust, Care of Tracy Groom, Cramlington, UK
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