Table 3.

Adverse effects associated with long-term administration of antimicrobial lock solutions.

Antimicrobial Lock Solution	Adverse Events	References
Antibiotics	Bacterial resistance	Pittiruti et al. 2009 [3] Mermel et al. 2009 [4]
Heparin a	Promotion of Staphylococcus aureus growth and biofilm formation	Shanks et al. 2005 [46]
Taurolidine b	No serious side effects were reported	Wouters et al. 2018 [59] Wouters et al. 2019 [64] Klek et al. 2015 [58] Bisseling et al. 2010 [57] Olthof et al. 2013 [65]
Ethanol	Catheter damage Systemic toxicities (DIC, deep venous thrombosis, hemolysis) Alcohol taste, nausea, vomiting	Mermel et al. 2014 [52] Visek et al. 2019 [36]

DIC: disseminated intravascular coagulation. ^a When heparin is administered at a concentration below 6000 units/mL. ^b No serious side effects were reported with different concentrations of Taurolidine (2%; 1.35%).