| Methods |
Single‐centre RCT (USA) |
| Participants |
Quote: “Patients who required the insertion of a fresh central venous or arterial catheter were invited to participate in the project. Patients allergic to cephalosporins and patients who were anticipated to need catheters for less than 2 days were excluded." Patients with a catheter in place for longer than 7 days were excluded as well, as stated in the Results, although this criterion was not stated in the Methods |
| Interventions |
CVCs with the antibiotic cefazolin bonded to TDMAC (cationic surfactant trododecylmethylammonium chloride) material compared with uncoated CVCs |
| Outcomes |
Catheter colonization (referred to as 'catheter infection' in this study), CRBSI and attributed mortality, skin or insertion site colonization, catheter‐related local infection or inflammation |
| Notes |
This study included both venous and arterial catheters, although data were available specifically for venous catheters. Only data for venous catheters were included in this systematic review. Sources of funding: industry (catheter manufacturer or distributor) |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
High risk |
Quote: “Catheters were randomized by the patient’s hospital number." This suggests an alternate rather than a truly randomized form of allocation |
| Allocation concealment (selection bias) |
High risk |
Quote: “Catheters were randomized by the patient’s hospital number." This suggests an alternate form of allocation, which carries a high risk of bias due to inadequate allocation concealment |
| Blinding of participants and personnel (performance bias)
All outcomes |
Low risk |
The authors stated that the 2 catheters were identical in appearance, except that the study catheters were coated with extra materials. They stated that all catheters were inspected daily by a member of the study team who was blinded to the participants' catheter group. The statements suggest that the participants and clinical outcome assessors were likely to be blinded |
| Blinding of outcome assessment (detection bias)
Microbiological outcomes like catheter colonization |
Unclear risk |
It was not mentioned whether the microbiological outcome assessors were blinded to the status of the catheter samples |
| Blinding of outcome assessment (detection bias)
Clinical outcomes like CRBSI |
Low risk |
The authors stated that the 2 catheters were identical in appearance except that the study catheters were coated with extra materials. They stated that all catheters were inspected daily by a member of the study team who was blinded to the participants in the catheter group. The statements suggest that the participants and clinical outcome assessors were likely to be blinded |
| Incomplete outcome data (attrition bias)
All outcomes |
Unclear risk |
147/178 catheters (82.6%) and 124/141 participants (87.9%) in total (venous and arterial combined) were analyzed. However there was no separate mention of drop‐outs for CVCs only. Reasons for exclusion included a catheter indwelling time of over seven days and non‐removal of the catheters when the participants left the ICU |
| Selective reporting (reporting bias) |
Unclear risk |
All the outcomes defined in the Methods, including catheter colonization, CRBSI and catheter‐related local infection or inflammation were reported in sufficient detail in the Results |
| Other bias |
Low risk |
None identified |
