^{作者：CHARMAINE E. LOK, KENNETH E. STANLEY, JANET E. HUX, ROBERT RICHARDSON,  SHELDON W. TOBE and JOHN CONLY}

^{來源：J Am Soc Nephrol 13: 169–179,} 

^{摘要：無法采用永久性血管通路的血液透析病人依賴于中央靜脈導管。在這類病人中，導管相關性感染是普遍且嚴重的并發癥。本隨機臨床試驗用來確定在中心靜脈導管插入位置使用Polysporin三抗生素軟膏是否可以降低導管相關性感染的影響。在雙盲試驗中，共有169位通過中心靜脈導管進行血液透析的患者隨機使用了Polysporin或安慰劑。結果顯示，在為期六個月的研究階段內，安慰劑組中比使用Polysporin組中病人感染率高。（34%對12%；相對風險，0.35；95% CI，0.18 對 0.68；P=0.0013），每1000導管使用天數感染的數量(4.10 對 1.02; P=.0001)和每1000導管使用天數的菌血癥的數目（2.48 對 0.63; P=0.0004）在安慰劑組都高。在六個月的研究期內，安慰劑組死亡13例，而Polysporin組有三例死亡（P=0.0041）。綜合所有隨訪信息，患者生存區別數據具有顯著意義 (19對9的死亡率; P=0.0027)。在最初的6個月中，研究顯示，安慰劑組中13個死亡病人有7位發現被感染（54%），相對于Polysporin 組中死亡的3個并沒有發現感染。在中心靜脈導管插入的部位局部使用Polysporin抗生素軟膏預防感染，可以降低感染的發生幾率，改善血液透析病人的生存率。}

^{J Am Soc Nephrol 13: 169–179, 2003}

^{Hemodialysis Infection Prevention with Polysporin Ointment}

^{CHARMAINE E. LOK,*? KENNETH E. STANLEY,? JANET E. HUX,*}

^{ROBERT RICHARDSON,* SHELDON W. TOBE,* and JOHN CONLY*}

^{*University of Toronto, Toronto, Canada; and ?Harvard School of Public Health, Boston, Massachusetts.}

^{Abstract. Hemodialysis patients in whom permanent vascular access cannot be achieved are dependent on a central venous catheter. In such patients, catheter-related infections are a common and serious complication. This study was a randomized clinical trial to determine if topical Polysporin Triple}

^{antibiotic ointment applied to the central venous catheter insertion site could reduce the incidence of catheter-related infections. A total of 169 patients receiving hemodialysis through a central venous catheter were randomized to receive Polysporin Triple or placebo using a double-blind study design. In the 6-mo study period, infections were observed in more patients in the placebo group than in the Polysporin Triple group (34 versus 12%; relative risk, 0.35; 95% CI, 0.18 to 0.68; P _ 0.0013). The number of infections per 1000 catheter days (4.10 versus 1.02; P _ 0.0001) and the number of bacteremias per 1000 catheter days (2.48 versus 0.63; P _ 0.0004) were also greater in the placebo group. Within the 6-mo study period, there were 13 deaths in the placebo group as compared with 3 deaths in the Polysporin Triple group (P _0.0041). When all available follow-up information was included, the difference in survival remained significant (19 versus 9 deaths; P _ 0.0027). Within the first 6 mo, infections were observed in 7 of the 13 placebo subjects who died (54%) as compared with no infections in the three Polysporin Triple subjects who died. The prophylactic application of topical Polysporin Triple antibiotic ointment to the central venous catheter insertion site reduced the rate of infections and was associated with improved survival in hemodialysis patients.}