2004 AJKD--Dialysis catheter-related bacteremia: treatment and prophylaxis. vs. 2004 AJMS--Hemodialysis vascular catheter-related bacteremia.

Dialysis catheter-related bacteremia: treatment and prophylaxis.

More recent studies suggested that instillation of an antibiotic-anticoagulant lock into the catheter lumen, as an adjunct to systemic antibiotic therapy, can cure approximately two thirds of catheter-related bacteremias without requiring catheter replacement. 

用lock therapy for perm cath (suspected Perm cath related CRBSI) 只有三分之二的成功率，而不用換掉。其實成功率還是不夠高。

Hemodialysis vascular catheter-related bacteremia.

Bacteremia in patients with catheters results from luminal or extraluminal contamination and may be perpetuated by infected fibrin sheaths associated with the catheter. Bacteremic patients require antibiotic therapy and catheter removal. Guide wire catheter exchange is appropriate in stable patients, but catheter removal and later reinsertion of a new catheter is indicated for tunnel infection or frank sepsis.

看來，要in-line change，並不建議在tunnelled catheter，而比較適合用在non-tunnelled catheter（？）。

當然，在IDSA 2011年的guideline也沒有絕對禁止in-line change這件事。