Effectiveness of silver sulfadiazine-coated catheters in preventing thrombophlebitis in hospitalized foals.

Abstract

BACKGROUND: Sick neonatal foals often need venous catheters, which can lead to thrombosis and infection. In human medicine, antimicrobial-coated catheters are widely used to prevent catheter bacterial colonization and catheter-related infections. HYPOTHESIS/OBJECTIVES: The aim was to assess the occurrence and risk factors for thrombophlebitis in hospitalized foals and determine whether using antimicrobial silver sulfadiazine (SS)-coated catheters prevented this condition. ANIMALS: A total of 170 hospitalized foals received a jugular venous over-the-wire long-term catheter. METHODS: Open-label randomized controlled trial. Foals were randomly assigned to either the SS-coated catheter group or the standard (ST) catheter group, and thrombophlebitis occurrence was compared using the chi-square test. The time to thrombophlebitis development was assessed using Kaplan-Meier methods. A penalized logistic regression using the least absolute shrinkage and selection operator (LASSO) was performed to identify risk factors. RESULTS: The study involved 83 foals in the SS group and 87 in the ST group. Thrombophlebitis occurred in 19.4% of cases, with 23.0% in the ST group and 15.7% in the SS group, although this difference was not statistically significant (P-value = .23). Silver sulfadiazine group foals developed thrombophlebitis later than the ST group (5 days vs 3 days, log-rank test: P-value = .015). The risk factors for the development of thrombophlebitis included age under 3 days, the presence of diarrhea, the presence of fever, administration of low-molecular-weight heparin, and a catheter dwell time of 19 days, while a higher placement score was protective against thrombophlebitis. CONCLUSIONS AND CLINICAL IMPORTANCE: Silver sulfadiazine-coated catheters delay thrombophlebitis development and are well tolerated.