SHM Converge Scientific Abstract ePoster Gallery-Are Midlines Safe for Outpatient Parenteral Antimicrobial Therapy With Vancomycin?

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This study examined whether midline catheters are safe for outpatient parenteral antimicrobial therapy (OPAT) with vancomycin compared with peripherally inserted central catheters (PICCs).<br /><br />Researchers retrospectively analyzed 2,387 devices placed at 69 Michigan hospitals from 2016 to 2023 in hospitalized adults discharged on vancomycin for OPAT. About 18% of devices were midlines and 82% were PICCs. Midlines had a shorter median dwell time (13 days) than PICCs (21 days).<br /><br />The main outcomes were serious catheter complications: catheter-related bloodstream infection (CRBSI) and catheter-related venous thromboembolism (CR-VTE). Secondary outcomes included minor catheter problems such as dislodgement, occlusion, infiltration, and superficial thrombosis, as well as device failure requiring removal.<br /><br />After adjusting for patient and catheter factors, midlines were associated with higher risks of serious device-related adverse events and device failure than PICCs. The study’s conclusion was that midlines appear less safe than PICCs when used for OPAT with vancomycin.<br /><br />The authors note that the findings support caution in using midlines for vancomycin outpatient therapy and suggest that future research should explore why hospitals vary in their practice. Because the study was observational and based on retrospective medical record review, residual confounding remains a limitation.

Asset Subtitle

David Paje

Meta Tag

Author List Anurag N. Malani, David Paje, Elizabeth McLaughlin, Emily A. Walzl, Jennifer K. Horowitz, Megan Heath, Scott A. Flanders, Steven J. Bernstein, Valerie M. Vaughn, Vineet Chopra

Category Research

Concept Midline Catheter

Concept PICC Line

Concept Catheter-Related Bloodstream Infection

Concept Catheter-Related Venous Thromboembolism

Concept Outpatient Intravenous Therapy

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author David Paje

Track Patient Safety

Keywords

midline catheters

PICC lines

vancomycin

OPAT

outpatient parenteral antimicrobial therapy

catheter complications

bloodstream infection

venous thromboembolism

device failure

retrospective study

Midline Catheter

PICC Line

Catheter-Related Bloodstream Infection

Catheter-Related Venous Thromboembolism

Outpatient Intravenous Therapy