Abstract
Totally implantable central venous access ports (TICVAP) have long been routinely used in cancer chemotherapy. During M/XDR-TB treatment TICVAP can be used in order to avoid daily intramuscular or intravenous injections through peripheral veins over a period of several months. The studies on feasibility and safety of TICVAP in M/XDR-TB treatment are lacking.
The aim of the study is to evaluate feasibility and safety of TICVAP use for M/XDR-TB treatment.
Patients with confirmed M/XDR-TB who started treatment with regimens containing carbapenems and/or second line injectables were enrolled. TICVAP feasibility was assessed, complications were recorded and analyzed.
Between 1 June 2015 and 1 December 2016, 54 TICVAPs were implanted in 52 patients: median age 32 years (range: 14-65); 38(70%) male; 40(74%) previously treated; 5(9%) HIV co-infected. The following veins were used as route: right (34) and left (7) subclavian, right (6) and left (5) jugular; right femoral (2). Seven complications were observed, 5(9%) - required removal, 2(4%) TICVAPs were re-implanted: pneumothorax -1 (pleural tube -1); lumen occlusion -2 (removal -2 and re-implantation -2), pocket and tunnel infection -2 (removal -2), TICVAP-related venous thrombosis -2 (removal -1, anticoagulant therapy -1). All complications were resolved without consequences. Majority of patients 49(94%) and health care practitioners reported advantage of TICVAP over the other types of venous access and intramuscular injections.
Conclusions: The study demonstrates high levels of patient acceptability and treatment adherence using TICVAP with reasonable level of safety. The experience gained can promote this approach for further expansion in programmatic settings.
- Copyright ©the authors 2017