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Preventing Infection using Antibiotic Impregnated Long Lines

Prevail

Preventing Infection using Antibiotic Impregnated Long Lines
Funding NIHR HTA
Portfolio Paediatric, foetal and maternal health
Interventions Device
Randomised Yes
Status Completed
Start Date 12-Aug-2015

Many babies admitted to neonatal intensive care need fluids and medicines given to them through their veins. This is done via a very narrow tube placed through the skin of the arm or leg and into a central vein. This tube is called a peripherally inserted central catheter (PICC). A PICC can also be referred to as a ‘long line’. Babies on a neonatal unit often need to take medicines and fluids though these PICCs for a long time.
PICCs are inserted in order to avoid the need for repeated painful procedures and can stay in place for several weeks. However, very occasionally these PICCs can cause infections in the blood.
There are currently two types of PICCs available, one is coated with an antibiotic (rifampicin) and an antifungal (miconazole), which might prevent infection by killing bacteria, and the other one has no antibiotic or antifungal coating (a standard PICC).
Although both are available, currently hospitals tend to use the standard PICC. PREVAIL investigated which PICC is better in babies or if there was no difference between them. PREVAIL took place across 18 neonatal units in the UK and 861 babies took part over two years.
We found no evidence of benefit or harm associated with miconazole and rifampicin-impregnated PICCs compared with standard PICCs for newborn babies. Future research should focus on other types of antimicrobial impregnation of PICCs and alternative approaches for preventing infection.

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Publications

  • Gilbert R, Brown M, Rainford N, Donohue C, Fraser C, Sinha A, Dorling J, McGuire W, Gamble C, Oddie SJ. Antimicrobial impregnated central venous catheters for preventing neonatal bloodstream infection: pragmatic, randomised controlled trial (The PREVAIL Trial). The Lancet Child and Adolescent Health
    1. https://doi.org/10.1016/S2352-4642(19)30114-2