Total parenteral nutrition (TPN) patients require central venous catheters to provide them with nutrition. While this care method has been instrumental in giving patients the nutrients they need, catheter line-associated bloodstream infection (CLABSI) is a serious risk associated with this treatment.
Ethanol lock therapy (ELT) has been proven effective in reducing the risk of CLABSI. Yet, recent supply shortages have forced patients to switch to less effective antimicrobial solutions to fight infection. So today, we’re diving into what ELT is, its benefits, and how ContinuumRx continues to provide ELT through this national healthcare issue.
What Is Ethanol Lock Therapy (ELT)?
To understand ELT, first, we have to take a look at CLABSI. When intravascular catheters are inserted, matrices called biofilms are created. Within these biofilms, microorganisms form and can detach from the biofilms and enter the bloodstream, thus causing a CLABSI. Unfortunately, due to the stubborn nature of the biofilm microorganisms, typical antibiotic therapy is not always effective in treating CLABSI, and generally, the infection is difficult to clear.
ELT is a method of care that aims to prevent CLABSI before it starts by injecting ethanol and allowing it to dwell in the central venous catheter to kill these harmful microorganisms. However, not all methods of ELT are successful in combating infection. The most effective method requires using a 70% ethanol solution for a dwelling period of four hours daily.
What Are the Benefits of ELT?
ELT can be a life-saving treatment for a TPN patient due to the severity of these types of infections. According to a study published by the American Society of Enteral and Parenteral Nutrition (ASPEN), CLABSI is the second most common cause of morbidity in TPN patients. Another ASPEN study stated, ‘ethanol lock use has been associated with significantly lower rates of central line-associated bloodstream infection (CLABSI) in children with intestinal failure.’ So, if the benefits of ELT are widely known, then why aren’t more patients utilizing it?
The initial rise in popularity around ELT stemmed from its affordability and accessibility. The price of ethanol was substantially lower than other antimicrobial solutions, and it was readily available to most medical professionals. For this reason, many physicians began prescribing ELT to their patients daily to help prevent CLABSI.
Recently, the US Food and Drug Administration (FDA) gave an orphan drug designation to Ablysinol, a dehydrated alcohol made by Belcher Pharmaceuticals, for treating a rare form of cardiomyopathy. This patent prohibited other manufacturers from producing dehydrated, sterile ethanol, resulting in a nationwide ethanol shortage and price increase. Care providers can no longer afford to administer ELT regularly, and since it is most effective when used daily, this has led to an increase in CLABSI nationwide.
How Is ContinuumRx Helping?
“Recently many providers began workarounds to avoid providing ELT to their patients due to the extreme price increase.”
Keith Hartman, Chief Executive Officer, ContinuumRx
As a result, many patients have been forced to use alternative, less effective methods such as heparin lock therapy (HLT) to avoid infection. However, even with the alternative methods, the rate of CLABSI has risen again to the historical level it was at before ELT became common practice, according to ASPEN.
Despite the shortage, ContinuumRx continues to provide ELT to its patients at a reasonable price point. We believe that no patient should have to settle for a less effective method of care because of inflated ethanol prices. Continuing to deliver quality care no matter the circumstances is just one of the many ways we help our patients through the healthcare continuum.
If you or your loved one is a TPN patient in need of ELT, we can work with your healthcare provider to deliver your treatment at home and restore your peace of mind. So don’t wait; call us today to onboard your therapy.