Guideline

Guidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part 2: central venous catheters

Year of Publication

2026

Issuing Institution

World Health Organization

Links

WHO IRIS

Recommendations

25 included recommendations

WHO suggests using a chlorhexidine containing body wash (liquid or impregnated wipes) daily in critically-ill adults, adolescents and children. (Short- and long-term catheters)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using a sterile technique involving maximal sterile barrier precautions over a sterile technique not involving maximal sterile barrier precautions at the time of central venous catheter (CVC) insertion in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests using an alcohol based formulation over an aqueous-based antiseptic formulation for skin disinfection before central venous catheter (CVC) insertion in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using an alcohol chlorhexidine antiseptic (1% or 2%) over other antiseptics (alcohol-iodine or alcohol alone or aqueous formulations) for skin disinfection before central venous catheter (CVC) insertion in adults, adolescents and children. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using either a transparent semi-permeable dressing or gauze dressing after central venous catheter (CVC) insertion in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests using an antiseptic patch or dressing (for example, a chlorhexidine gluconate- impregnated sponge or dressing or any other antiseptic) at the central venous catheter (CVC) insertion site in adults, adolescents and children. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using a formal schedule of central venous catheter (CVC) dressing changes in adults, adolescents, children, and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

If a formal schedule of central venous catheter (CVC) dressing changes is to be used, WHO suggests using dressing change intervals of 3 days or more in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests using either a continuous IV infusion or an intermittent infusion for the maintenance of central venous catheters (CVCs) in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests a system of “lockoff” flushing with normal sterile saline over “lock-off” flushing with heparinized saline for central venous catheters (CVCs) in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests using a schedule of regular changing of the central venous catheter (CVC) administration set (tubing/giving) every 7 days over other schedules (2, 3, 4 days) when administering routine IV fluids only in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests regular changing of the central venous catheter (CVC) administration set (tubing/giving) after administering total parenteral nutrition or lipid products in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests using either a closed access or an open-access central venous catheter (CVC) hub system in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests against routinely replacing a central venous catheter (CVC) (unless clinically indicated) in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended against

Conditional

Certainty of evidence

Very low

WHO suggests using the subclavian or jugular veins over the femoral vein for central venous catheter (CVC) insertion in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using the subclavian veins as the preferred site over jugular veins (if no contraindications) for central venous catheter (CVC) insertion in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using either antibiotic impregnated or non-impregnated central venous catheters (CVCs) in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using antiseptic coated central venous catheters (CVCs) in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using a single lumen over a multi-lumen catheter (unless there is a specific reason that requires multiple lumens) in adults, adolescents, children and neonates requiring a long-term line. (Long-term catheters only) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests using either a Hickman central venous catheter (CVC) or a Port-a-Cath in adults, adolescents, children and neonates requiring a long-term line. (Long-term catheters only) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests using either a sutureless or suture-based securement of central venous catheters (CVCs) in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests not using an antimicrobial lock solution in patients with short-term central venous catheters (CVCs) for the prevention of CVC infections in adults, adolescents, children and neonates. (Short-term catheters only) (All population)

Status

New

Recommended against

Conditional

Certainty of evidence

Very low

WHO suggests either using antiseptic impregnated or non-impregnated line caps in adults, adolescents, children and neonates with short- and long-term catheters. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests not using IV prophylactic antibiotics in adults, adolescents, children and neonates with short- and long-term catheters.(Short- and long-term catheters)

Status

New

Recommended against

Conditional

Certainty of evidence

Very low

WHO suggests using central venous catheter (CVC) practice bundles in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low