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ClearGuard HD antimicrobial barrier caps for preventing haemodialysis catheter-related bloodstream infections

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1 Recommendations

1.1 ClearGuard HD antimicrobial barrier caps are recommended for preventing catheter-related bloodstream infections in people with central venous catheters having haemodialysis.

1.2 Do not use ClearGuard HD caps in people allergic to chlorhexidine.

1.3 Cost modelling shows that over 1 year ClearGuard HD caps are likely to be cost saving compared with standard treatments. ClearGuard HD caps are estimated to save, per person:

  • £351 compared with standard caps and wipes

  • £1,096 compared with antimicrobial line lock solution, standard caps and wipes

  • £568 compared with Tego needleless connector and Curos disinfecting caps.

    Savings were from the lower incidence rate and associated cost of treating catheter-related bloodstream infection with ClearGuard HD caps.

Why the committee made these recommendations

ClearGuard HD caps are used with central venous catheters in haemodialysis. They are different from standard caps because they contain a rod that is coated in the antimicrobial chlorhexidine acetate to prevent infection. Other options for preventing infection are the Curos disinfecting cap, used with Tego needleless connectors, and antimicrobial line lock solutions.

Clinical evidence shows that using ClearGuard HD caps instead of standard caps, Tego plus Curos, or line lock solutions reduces the risk of catheter-related bloodstream infections.

Cost analysis shows that they lead to cost savings because of reduced infections.

Therefore, ClearGuard HD caps are recommended.