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Critical Care
Published in: Critical Care 1/2013

01-02-2013 | Commentary

Topical honey: for bears, not for ICU catheters?

Author: Jean-François Timsit

Published in: Critical Care | Issue 1/2013

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Abstract

Catheters are most often colonized and become infected via the skin and their external surfaces in the ICU. Therefore, topical antimicrobials, including medical honey, placed at the insertion site should decrease skin colonization and catheter infections. This commentary reviews the main studies on, and the possible reasons of, topical antimicrobial failure in ICUs compared to the reported efficacy of chlorhexidine-impregnated dressings.
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Maki DG, Band JD: A comparative study of polyantibiotic and iodophor ointments in prevention of vascular catheter-related infection. Am J Med 1981, 70: 739-744. 10.1016/0002-9343(81)90605-7CrossRefPubMed
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Timsit JF, Schwebel C, Bouadma L, Geffroy A, Garrouste-Orgeas M, Pease S, Herault MC, Haouache H, Calvino-Gunther S, Gestin B, Armand-Lefevre L, Leflon V, Chaplain C, Benali A, Francais A, Adrie C, Zahar JR, Thuong M, Arrault X, Croize J, Lucet JC, Dressing Study Group: Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA 2009, 301: 1231-1241. 10.1001/jama.2009.376CrossRefPubMed
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Timsit JF, Mimoz O, Mourvillier B, Souweine B, Garrouste-Orgeas M, Alfandari S, Plantefeve G, Bronchard R, Troche G, Gauzit R, Antona M, Canet E, Bohe J, Lepape A, Vesin A, Arrault X, Schwebel C, Adrie C, Zahar JR, Ruckly S, Tournegros C, Lucet JC: Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Criti Care Med 2012, 186: 1272-1278. 10.1164/rccm.201206-1038OCCrossRef
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Kwakman PH, de Boer L, Ruyter-Spira CP, Creemers-Molenaar T, Helsper JP, Vandenbroucke-Grauls CM, Zaat SA, te Velde AA: Medical-grade honey enriched with antimicrobial peptides has enhanced activity against antibiotic-resistant pathogens. Eur J Clin Microbiol Infect Dis 2011, 30: 251-257. 10.1007/s10096-010-1077-xPubMedCentralCrossRefPubMed
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Kwakman PH, Muller MC, Binnekade JM, van den Akker JP, de Borgie CA, Schultz MJ, Zaat SA: Medical-grade honey does not reduce skin colonization at central venous catheter insertion sites of critically ill patients: a randomized controlled trial. Crit Care 2012, 16: R214. 10.1186/cc11849PubMedCentralCrossRefPubMed
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Metadata
Title
Topical honey: for bears, not for ICU catheters?
Author
Jean-François Timsit
Publication date
01-02-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11900

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Competing interests declared: early interventions and long-term psychological outcomes