The efficacy of taurolidine lock solution in preventing catheter-related bloodstream infections in pediatrics: a systematic review and meta-analysis

Why clinicians should know about it

• Picked for Hematology (top studies of the week, 8 November 2026): Catheter infection prevention relevant to hematology and transplant care
• Picked for Pediatrics and Child Health (top studies of the week, 8 November 2026): Paediatric catheter infection prevention and treatment safety

Abstract

BACKGROUND: This systematic review and meta-analysis evaluated the efficacy and safety of taurolidine lock solutions in preventing catheter-related bloodstream infections in pediatric patients with central venous access devices. METHODS: This meta-analysis systematically searched four electronic databases to identify studies comparing taurolidine with standard lock solutions for catheter lock in pediatric patients. The primary outcome measure was the incidence density of catheter-related bloodstream infections. Secondary outcomes included the incidence density of central line-associated bloodstream infection, cumulative incidence of catheter-related bloodstream infections, catheter removal due to infection, central venous access device (CVAD)-related thrombosis, and adverse events. Random-effects models were used to pool incidence rate ratios (IRRs) for incidence-density outcomes and risk ratios (RRs) for dichotomous outcomes, with corresponding 95% confidence intervals. RESULTS: In the primary analysis of five studies, taurolidine-containing catheter lock solutions were associated with a significantly lower incidence rate of catheter-related bloodstream infection (CRBSI) compared with control solutions (IRR = 0.23, 95% CI: 0.15-0.36; I2 = 0%; P < 0.00001). The separate secondary analysis of three studies also showed a lower incidence density of central line-associated bloodstream infection (CLABSI), although substantial heterogeneity was observed (IRR = 0.25, 95% CI: 0.08-0.85; I2 = 90%; P = 0.03). The cumulative incidence of catheter-related bloodstream infections was lower in the taurolidine group (RR = 0.37, 95% CI: 0.23-0.61; I2 = 54%; P = 0.0001). No statistically significant differences were detected in catheter removal due to infection (RR = 1.25, 95% CI: 0.60-2.62; I2 = 12%; P = 0.56), CVAD-related thrombosis (RR = 0.88, 95% CI: 0.29-2.64; I2 = 0%; P = 0.82), or adverse events (RR = 3.93, 95% CI: 0.82-18.80; I2 = 64%; P = 0.09). CONCLUSION: Taurolidine-containing lock solutions may reduce the incidence density and cumulative incidence of CRBSI in pediatric patients requiring central venous access. However, the available evidence is insufficient to establish their comparative safety. Given the substantial heterogeneity, mixed study designs, variability in infection definitions, and limited safety data, these findings should be interpreted cautiously. Further large-scale, multicenter randomized controlled trials with adequate safety monitoring are needed before broad routine implementation can be recommended. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251162414 identifier, CRD420251162414.

Abstract as published, via PubMed.