Antimicrobial Catheter Lock Solution to provide patency and infection control
TauroLock™ is non-antibiotic catheter lock solution that is used for the prevention and treatment of catheter related blood stream infections in dialysis, oncology and parenteral nutrition. It has to be instilled in the device lumens between treatments in order to make the internal flow passages resistant to clot formation and hostile to bacterial and fungal growth. TauroLock™ is suitable for use for all tunnelled and non-tunnelled vascular access and port systems.
Prophylaxis against catheter related bloodstream infections:
Central venous catheters (CVC) are used as short or long term vascular access devices in haemodialysis, oncology, ICU and parenteral nutrition. High risks for CVC malfunction are catheter-related infections (CRI). These infections may be triggered by microbial colonisation of the catheter from which the microorganisms can spread into the bloodstream. CRI may develop septic symptoms which would require the immediate removal of the catheter.
TauroPharm catheter lock solutions do not contain antibiotics and were developed for prophylactic use to reduce CRI. The antimicrobial activity of TauroLock™ is based on taurolidine which is bactericidal, including against resistant bacteria such as MRSA and VRE, as well as fungicidal. They reduce CRI significantly (~ 90%).
CDC and ERBP demand the use of antimicrobial lock solutions such as TauroLock™ which is recommended by various national guidelines in dialysis, oncology and parenteral nutrition.
Prophylaxis against biological occlusion in the catheter:
All TauroLock™ solutions contain 4% citrate as an anticoagulant. This concentration removes calcium safely and effectively from the clotting cascade.
Based on one randomised study TauroLock™ increases the need for thrombolytic treatment vs. heparin 5.000 IU/ml in dialysis patients. Therefore, we recommend TauroLock™ HEP500 as standard lock solution in dialysis which is comparable to heparin regarding patency. The optional use of low concentrated heparin supports an anticoagulative effect via binding to antithrombin.
The combination of TauroLock™ HEP500 and TauroLock™ U25.000 (which contains urokinase) in a 2+1 protocol is a further regimen which significantly reduces patency problems in two randomised studies versus citrate 4% (p=0.006, Winnicki et al) or TauroLock™ HEP500 (p=0.004, Al-Ali et al).
To date, there are no known adverse effects in humans when used as recommended.
- TauroLock™ contains a citrate concentration of 4% - according to the FDA recommendation of April 2000, this concentration is both safe and effective.
- Low concentrations of citrate can cause mild hypocalcaemic symptoms if the instillation rate is too high.
- The use of highly concentrated citrate solutions can be associated with severe adverse effects (cardiac arrhythmia, embolic complications). TauroLock™ does not cause similar adverse effects.
- In contrast to highly concentrated citrate, 4% citrate is not associated with protein precipitation.
- TauroLock™ is available both without heparin and with low heparin concentrations (TauroLock™HEP100 and TauroLock™ HEP500). This allows undesired bleeding elicited by heparin to be prevented.
- In HIT patients, TauroLock™ without heparin needs to be used.
- TauroLock™ is biologically compatible and non-toxic.
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