Dialysis Line Infection — ESENeph MCQ

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EasyHaemodialysisDialysis Line InfectionESENeph

A 60-year-old man on haemodialysis via a tunnelled line develops a temperature of 38.8°C during a dialysis session. Blood cultures are taken from the line and peripherally. What is the most appropriate empirical antibiotic regimen?

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Correct answer: B — Vancomycin and Gentamicin

UKKA (formerly UK Renal Association) vascular access guidelines recommend empirical treatment of tunnelled line infection with Vancomycin (to cover MRSA and coagulase-negative staphylococci) plus Gentamicin (Gram-negative cover). Local antibiotic policies may vary but this combination provides broad-spectrum empirical cover pending culture results. Single-agent Gram-positive cover alone is insufficient.

Reference: UK Kidney Association 2019 – Clinical Practice Guideline: Vascular Access for Haemodialysis