Frequently Asked Questions

What is Cook Spectrum effective against?

Spectrum is effective against a broad spectrum of bacteria that commonly cause CLABSIs/CRBSIs, including gram positive, gram negative, and some fungi (e.g. CNS, MRSA, VRE, and VRSA).

Where can I find the studies that support the use of Spectrum?

Links to the studies' abstracts can be found under Evidence & Guidelines or by contacting your local Cook representative.

Does Spectrum have any contraindications?

Allergy or history of allergy to tetracyclines or rifampin NOTE: Because Spectrum catheters are impregnated with a combination of the antimicrobial agents minocycline (a derivative of tetracycline) and rifampin (a derivative of rifamycin B), the contraindications, warnings, and precautions regarding use of these antimicrobials apply and should be adhered to for use of this device, although systemic levels of minocycline and rifampin in patients receiving this device are highly unlikely to result from their use. Minocycline and rifampin are agents that do not induce any genotoxic risk except a possible teratogenic effect in pregnant women. We therefore do not recommend the use of Spectrum Silicone Peripherally Inserted Central Venous catheters in pregnant women.

For how long is Spectrum technology effective against microbes that cause CRBSIs?

The duration of Spectrum technology’s effectiveness depends on the bacterium. Against methicillin-resistant Staphylococcus aureus (MRSA), Spectrum has antimicrobial durability of at least 35 days.1 Against vancomycin resistant Staphylococcus aureus (VRSA), MDR A. baumannii/calcoaceticus, MDR E. agglomerans, and MDR S. maltophilia, Spectrum has antimicrobial durability of at least 28 days.2 Against coagulase-negative Staphylococci (CNS) and Candida albicans, the half-life of the inhibitory activity of catheters coated with minocycline and rifampin was 25 days.3

Are there any antibiotic-resistance issues?

Over 20 years of clinical use have shown no evidence that minocycline and rifampin (M+R) catheters lead to increased bacterial resistance, and a 7 year study of over 500,000 catheter days confirms these results. 4

Do I need to use a special technique in placement or care?

Care for a Spectrum catheter just as you would any catheter. Cook recommends that you follow maximum sterile barrier precautions during placement and follow your institution’s protocol to care for the catheter.

Do I still need to use my standard patient prep process and postcare practices?

Yes, follow all of the normal practices that your institution has in place, including, but not limited to, proper skin prep, dressing changes, and best practices for accessing and flushing.

Is a Spectrum Catheter compatible with all antibiotics and other therapies?

The Spectrum catheter is compatible with all standard infusates.

Can antiseptic dressings be used with a Spectrum Catheter?

Yes. Antiseptic dressings are compatible with minocycline and rifampin - the antibiotics impregnated within Cook Spectrum catheters. The additional benefit of using antiseptic dressings with Spectrum has not been studied.

Will a Cook Spectrum catheter treat a current infection?

No, Spectrum catheters are only for the prevention of CRBSIs, not for the treatment of an active infection.

If the patient gets a CRBSI while being treated with a Spectrum catheter, does Spectrum technology prohibit standard care?

No, neither minocycline nor rifampin are current mainstream antibiotics in the treatment of bloodstream infections, so they will not inhibit the use of your institution's normal antibiotic therapies.

Is minocycline or rifampin detectable in the bloodstream?

No. Since the antibiotics are impregnated into the material, they are released slowly over time and are not detectable in the patient’s blood. The maximum amount of antibiotic present in a catheter is 1/10 of one systemic dose for normal therapies.5

Which types of catheters are available with Cook Spectrum technology?

Cook provides several different types of central venous catheters with Spectrum technology. These include PICCs, hyperalimentation catheters, acute CVCs, and long-term CVCs. Please contact your local Cook representative for further details.

Where was Cook Spectrum technology developed?

The process of impregnating catheters with minocycline and rifampin (Spectrum) was developed by a team led by Dr. Issam Raad and Dr. Rabih Darouiche. Dr. Raad is chair of infectious disease at M.D. Anderson Cancer Center in Houston, Texas.

Dr. Darouiche is chair of infectious disease at the Medical College of Baylor in Houston, Texas.

Can Spectrum catheters be used for power-Injection?

Yes, several configurations of Spectrum catheters can be used for power injection. Please refer to the products page for a full listing.

Does Cook provide education on Spectrum catheters to Healthcare Professionals?

Cook Medical provides training and support through in-servicing and custom workshops. We work with experts in the field to offer educational opportunities that will help you and your team keep up on the latest trends in medicine. Training is offered on a variety of topics and can be tailored to a format that fits your needs. For a full explanation of additional education offered by Cook, visit the education page of this site.

Where can I find guidelines for Infection Prevention and patient safety?

You can find a list of guidelines for infection prevention and patient safety here.

References
  1. Hanna H, Benjamin R, Chatzinikolaou I, et al. Long-term silicone central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: a prospective randomized clinical trial. J Clin Oncol. 2004;22(15):3163-3171.
  2. Raad I, Reitzel R, Jiang Y, et al. Anti-adherence activity and antimicrobial durability of anti-infective-coated catheters against multidrug-resistant bacteria. J Antimicrob Chemother. 2008;62(4):746-750.
  3. Raad I, Darouiche R, Hachem R, et al. The broad-spectrum activity and efficacy of catheters coated with minocycline and rifampin. J Infect Dis. 1996;173(2):418-424.
  4. Ramos ER, Reitzel R, Jiang Y, et al. Clinical effectiveness and risk of emerging resistance associated with prolonged use of antibiotic-impregnated catheters: more than 0.5 million catheter days and 7 years of clinical experience. Critical Care Medicine. 2011;39(2): 245-251.
  5. Raad I, Darouiche R, Dupuis J, et al. Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections: a randomized, double-blind trial. Ann Intern Med. 1997;127(4):267-274.