Peripheral intravenous catheter-related phlebitis

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 155; no. 40; p. A3548
• Main Authors: van der Sar-van der Brugge, Simone, Posthuma, E F M Ward
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 2011
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Catheter-Related Infections - epidemiology; Catheter-Related Infections - prevention & control; Catheterization, Peripheral - adverse effects; Floxacillin - adverse effects; Floxacillin - therapeutic use; Humans; Immunocompromised Host; Male; Phlebitis - epidemiology; Phlebitis - etiology; Staphylococcal Infections - epidemiology; Staphylococcal Infections - etiology; Staphylococcal Infections - prevention & control; Treatment Outcome
• ISSN: 0028-2162; 1876-8784

Phlebitis is a very common complication of the use of intravenous catheters. Two patients with an i.v. catheter complicated by thrombophlebitis are described. Patient A was immunocompromised due to chronic lymphatic leukaemia and developed septic thrombophlebitis with positive blood cultures for S. Aureus. Patient B was being treated with flucloxacillin because of an S. Aureus infection and developed chemical phlebitis. Septic phlebitis is rare, but potentially serious. Chemical or mechanical types of thrombophlebitis are usually less severe, but happen very frequently. Risk factors include: female sex, previous episode of phlebitis, insertion at (ventral) forearm, emergency placement and administration of antibiotics. Until recently, routine replacement of peripheral intravenous catheters after 72-96 h was recommended, but randomised controlled trials have not shown any benefit of this routine. A recent Cochrane Review recommends replacement of peripheral intravenous catheters when clinically indicated only.