Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney Disease
Authors: David Paje, Scott A. Flanders, Steven J. Bernstein, Vineet Chopra
Journal: Annals of Internal Medicine (2019)

Letters5 November 2019Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney DiseaseDavid Paje, MD, MPH, Scott A. Flanders, MD, Steven J. Bernstein, MD, MPH, and Vineet Chopra, MD, MScDavid Paje, MD, MPHUniversity of Michigan Medical School, The Patient Safety Enhancement Program, and Center for Clinical Management Research at VA Ann Arbor Healthcare System, Ann Arbor, Michigan (D.P.)Search for more papers by this author, Scott A. Flanders, MDUniversity of Michigan Medical School, The Patient Safety Enhancement Program, Center for Clinical Management Research at VA Ann Arbor Healthcare System, and Michigan Hospital Medicine Safety Consortium, Ann Arbor, Michigan (S.A.F., V.C.)Search for more papers by this author, Steven J. Bernstein, MD, MPHUniversity of Michigan Medical School, The Center for Clinical Management Research at VA Ann Arbor Healthcare System, and Michigan Hospital Medicine Safety Consortium, Ann Arbor, Michigan (S.J.B.)Search for more papers by this author, and Vineet Chopra, MD, MScUniversity of Michigan Medical School, The Patient Safety Enhancement Program, Center for Clinical Management Research at VA Ann Arbor Healthcare System, and Michigan Hospital Medicine Safety Consortium, Ann Arbor, Michigan (S.A.F., V.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0537 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Goodman cites several studies where use of oral antibiotics resulted in similar outcomes to intravenous antibiotics and obviated the need to place an intravenous device. Given the inappropriate use of PICCs in patients with CKD, he contends that earlier initiation of oral antibiotics may obviate the need for PICC placement. We could not agree more. Even before the recent trials cited by Dr. Goodman, studies suggested that oral antibiotic treatments were noninferior to intravenous ones in the pediatric setting (1, 2). Several possible factors explain why we have we not adopted this approach more broadly.First, old ...References1. Keren R, Shah SS, Srivastava R, et al; Pediatric Research in Inpatient Settings Network. Comparative effectiveness of intravenous vs oral antibiotics for postdischarge treatment of acute osteomyelitis in children. JAMA Pediatr. 2015;169:120-8. [PMID: 25506733] doi:10.1001/jamapediatrics.2014.2822 CrossrefMedlineGoogle Scholar2. Shah SS, Srivastava R, Wu S, et al; Pediatric Research in Inpatient Settings Network. Intravenous versus oral antibiotics for postdischarge treatment of complicated pneumonia. Pediatrics. 2016;138. [PMID: 27940695] CrossrefMedlineGoogle Scholar3. McGill RL, Tsukahara T, Bhardwaj R, et al. Inpatient venous access practices: PICC culture and the kidney patient. J Vasc Access. 2015 May-Jun;16:206-10. [PMID: 25634154] doi:10.5301/jva.5000340 CrossrefMedlineGoogle Scholar4. Parente DM, Morton J. Role of the pharmacist in antimicrobial stewardship. Med Clin North Am. 2018;102:929-36. [PMID: 30126581] doi:10.1016/j.mcna.2018.05.009 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Michigan Medical School, The Patient Safety Enhancement Program, and Center for Clinical Management Research at VA Ann Arbor Healthcare System, Ann Arbor, Michigan (D.P.)University of Michigan Medical School, The Patient Safety Enhancement Program, Center for Clinical Management Research at VA Ann Arbor Healthcare System, and Michigan Hospital Medicine Safety Consortium, Ann Arbor, Michigan (S.A.F., V.C.)University of Michigan Medical School, The Center for Clinical Management Research at VA Ann Arbor Healthcare System, and Michigan Hospital Medicine Safety Consortium, Ann Arbor, Michigan (S.J.B.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2937. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney Disease David Paje , Mary A.M. Rogers , Anna Conlon , Scott A. Flanders , Steven J. Bernstein , and Vineet Chopra Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney Disease Edward L. Goodman Metrics Cited by“Save the Vein” Initiative in Children With CKD: A Quality Improvement StudyMaking MAGIC: how to improve the use of peripherally inserted central catheters 5 November 2019Volume 171, Issue 9Page: 683-684KeywordsAntibioticsDisclosureDrug safetyDrugsHabitsHospital medicineInfectious diseasesNutritionPeripherally inserted central cathetersSafety ePublished: 5 November 2019 Issue Published: 5 November 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...