Vancomycin May Increase Risk of Midline Catheter Complications: Study

The medication often used to treat antibiotic-resistant bacteria has been linked to increased bloodstream infection risks.

A new study indicates patients receiving a common antibiotic through a midline catheter face an eight-fold risk of developing serious bloodstream infections.

According to findings published in the journal JAMA Internal Medicine on July 21, patients who were administered vancomycin through a midline catheter had a higher risk of suffering various complications than those who did not receive the antibiotic.

Vancomycin is an antibiotic used to treat bacterial infections, including several infections caused by antibiotic-resistant bacteria that are difficult to treat.

Midline catheters are inserted into a vein in the upper arm below the shoulder. They are designed to stay in place for longer periods because they are not placed in a central vein near the heart like other catheters.

Often, vancomycin is administered through a midline catheter for short periods while doctors wait for results of other tests. In some cases, they are even put into place for outpatient antibiotic therapy. However, current guidelines do not recommend using midline catheters for long-term vancomycin treatment due to the risk of side effects.

In this new study, which was led by Dr. David Paje, a University of Michigan research team found that using vancomycin with midline catheters may significantly increase the risk of serious complications. 

The findings come from an analysis of data collected by the Michigan Hospital Medicine Safety Consortium, involving more than 3,300 hospitalized patients who received outpatient midline therapy between January 2017 and August 2024.

Roughly 18% of the patients were treated with vancomycin, with catheters typically remaining in place for about 12 days. This group experienced major complications nearly three times more often than those who did not receive the drug (4.5% vs. 1.5%). They were also eight times more likely to develop a bloodstream infection (2.5% vs. 0.3%) and more than three times as likely to suffer a blood clot (2% vs. 0.6%). 

Overall, 17% of vancomycin patients faced catheter-related issues, including a nearly four-fold higher risk of major device failure and a 75% greater risk of catheter failure.

The authors say the results should prompt updated treatment guidelines and more cautious prescribing practices. With several safer alternatives to both vancomycin and midline catheters available, they recommend physicians weigh other options to reduce the risk of harm.

Port Catheter Lawsuits

Beyond the risks tied to medications like vancomycin, certain implantable port catheter systems have been linked to their own serious safety concerns. The Bard PowerPort and AngioDynamics port catheters have been associated with an increased risk of bloodstream infections due to designs that can harbor bacteria, as well as a heightened risk of fracture and migration linked to the use of barium sulfate in the device materials.

These devices, implanted under the skin to provide long-term vascular access, are commonly used for chemotherapy, antibiotic therapy and other repeated infusions. However, reports indicate that defects in their design can cause the catheter to crack or break apart, allowing pieces to travel through the bloodstream, or to shift out of place entirely. Such failures have been tied to severe and sometimes life-threatening injuries, including infections, blood clots and organ damage.

The mounting number of reported complications has led to the creation of two separate multidistrict litigations (MDLs), one for Bard PowerPort lawsuits and another for AngioDynamics lawsuits.

Plaintiffs in both litigations allege the manufacturers failed to warn patients and healthcare providers about the true scope of risks, despite evidence of long-standing design flaws.

Individuals who experienced complications from one of these devices may be eligible to pursue a lawsuit or settlement. A port catheter attorney can review the details of the case and advise on legal options for compensation.