Antimicrobial lock therapy (1631)

What is Antimicrobial Lock Therapy (ALT)?

An infection in the blood can happen when bacteria or germs move through a central line and go into the blood. Antibiotics or ethanol will be put into the central line to help get rid of the bacteria. This is called antimicrobial lock therapy (ALT).

How is it done?

• Your child will have blood drawn to see what type of bacteria is causing the infection. This is called a blood culture.
• Antibiotic medicine or ethanol will be put into the central line. This will help get rid of the bacteria inside the line.
• Blood tests will be done to see if the infection is going away.
• If the ALT does not get rid of the infection the line may have to be taken out.

Gather supplies

• Alcohol pads
• 10mL normal saline flushes
• IV medicine for the ALT

Starting the ALT

1. Make sure your work area is clean.
2. Wash your hands.
3. Scrub the cap at the end of the line:
   1. Scrub with an alcohol swab for 15 seconds. Use a twisting motion.
   2. Let it dry for 15 seconds.
4. Flush the catheter with 10mL normal saline. Use the push-pause-push method to flush.
   1. If the line is hard to flush, call your home care nurse or the Central Access Team at the hospital before going on to next step.
5. Remove the syringe.
6. Scrub the line with alcohol again.
7. Put the antibiotic or ethanol into the line.
   1. The ALT must remain in the line for several hours. The doctor will tell you how long to leave it in the line.
8. Put a warning sticker on the catheter. The line cannot be used while the ALT is in the line.

Removing the ALT

After the time has passed:

1. Make sure your work area is clean.
2. Wash your hands.
3. Scrub the cap at the end of the line.
4. Pull out the ALT using an empty 10ml syringe.
   1. Take out the same amount that was put in earlier.
5. Flush the catheter with 10mL normal saline using the push-pause-push method.
   1. Now the line can be used if needed.
   2. If the line won’t be used; cap with heparin or saline.

For more information

https://kidshealth.org/ChildrensWi/en/parents