Bibliographic information
GuidelineGuidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part 2: central venous catheters
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
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)
Recommended against
Conditional
Certainty of evidence
Very low
Notes and Remarks
- Concerns regarding ethanol as a lock solution were expressed by some GDG members and included the risk of causing catheter occlusion, increased risk of thrombosis, damage to the catheter material, and a potential for systemic toxicity if leaked into the bloodstream (328-330).
- Some GDG members expressed concerns about the potential development of AMR following the use of prophylactic antimicrobial lock therapy and the wider impact on bacterial epidemiology.
- For comparison among different agents, ethylenediaminetetraacetic acid (EDTA) was considered among the antimicrobials due to previous evidence suggesting antibacterial properties (331, 332).
- It should be noted that this recommendation is only relevant for short-term catheters
- An additional comment from GDG members was that it may be difficult to instil an antimicrobial lock solution in ICU settings where short-time CVCs are often in continuous use.