{"entity":{"id":"idea-upgrade-antiseptic-caps-for-long-term-lines-at-home","kind":"idea","name":"Test antiseptic caps on the connectors of PICCs and tunnelled lines in people having cancer treatment at home","aka":[],"tldr":"An antiseptic cap that sits on the end of a line's connector between uses may lower infections. The evidence comes mostly from hospital wards and intensive care; for people with cancer who live at home with a PICC or tunnelled line for months, NICE found too little evidence and asked for research.","summary":"The evidence. The SHEA/IDSA/APIC compendium (2022) lists antiseptic-containing caps as an additional practice despite high-level evidence, because they are not considered superior to manual disinfection, and lists as unresolved whether the connector still needs scrubbing when a cap is used. NICE (HealthTech guidance 510, 2019) found the Curos cap promising but the evidence insufficient for routine NHS adoption, and recommended research that explores \"the use of Curos in people at high risk of infection, including those whose condition is managed in the community\".\n\nThe gap. People having cancer treatment through a PICC or tunnelled line at home are at high risk of line infection, and their lines are accessed by different nurses in different places; no trial read was done in that group.","asOf":"2026-11-11","links":[{"label":"Buetti et al., Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update (Infect Control Hosp Epidemiol 2022)","url":"https://doi.org/10.1017/ice.2022.87"},{"label":"NICE HealthTech guidance 510 (formerly MTG44): Curos for preventing infections when using needleless connectors (2019)","url":"https://www.nice.org.uk/guidance/htg510/chapter/1-Recommendations"}],"tags":["protocol-upgrade","upgrade:promising","evidence:moderate"],"related":[],"cancers":[],"sections":["chemotherapy","supportive-care"],"technologies":["needleless-connector-disinfecting-caps","picc-lines"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["central-venous-access"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Antiseptic caps on needleless connectors of long-term lines in outpatients having anticancer treatment reduce catheter-related bloodstream infection compared with manual scrubbing alone.","rationale":"Caps take the step that depends on memory out of each access; the benefit should be largest where accesses are many and done by many hands.","test":"A randomised trial in adults with PICCs or tunnelled lines for anticancer treatment, caps plus manual scrub against manual scrub alone, with catheter-related bloodstream infection per 1,000 catheter days as the primary outcome.","maturity":"early-clinical","actor":"research","cost":"small","horizonYears":3},"route":"/ideas/idea-upgrade-antiseptic-caps-for-long-term-lines-at-home/","neighbours":{"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"needleless-connector-disinfecting-caps","kind":"technology","name":"Disinfecting caps for needleless connectors (Curos)","route":"/technologies/needleless-connector-disinfecting-caps/"},{"id":"picc-lines","kind":"technology","name":"Peripherally inserted central catheters (PICC lines)","route":"/technologies/picc-lines/"}],"term":[{"id":"central-venous-access","kind":"term","name":"Central venous access (port, PICC line)","route":"/terms/central-venous-access/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"protocol":[{"id":"picc-and-tunnelled-line-care","kind":"protocol","name":"PICC and tunnelled central line care: dressing, hub cleaning, flushing and living with the line","route":"/protocols/picc-and-tunnelled-line-care/"}]}}