A practical guide to evaluation and treatment of infections in patients with central venous catheters.

Infection in patients with central venous catheters can be a serious complication leading to costly disruption of their ongoing medical needs. A systematic, algorithm-based approach to evaluation and treatment of infections in this very diverse population is presented and emphasizes rapid and thorough determination of infection sources and outlines decisions regarding use of antibiotic therapy. Catheter-related infections, including bacteremia and exit site, tunnel, and pocket infections, can be treated in many cases without removal of the device. Recently developed treatment protocols and new technologies devised to decrease infection risk and improve outcome are discussed.