Intra-Articular Antibiotic Administration Through a Hickman Catheter

A Hickman catheter is a type of catheter used for long-term administration of medications such as antibiotics. When a Hickman catheter is used to deliver antibiotics to a joint (intra-articular antibiotic administration), it is surgically inserted, through skin and muscle, to the open space inside the joint (articular cavity). This direct route can be the most effective way to deliver antibiotics to an infected joint.

The catheter is held in place with stitches (sutures). These should be removed by your caregiver approximately 2 weeks after insertion of the catheter. The catheter generally is removed after about 6 weeks from the time it was inserted. Removal of the catheter is done surgically. After removal of the catheter, the incision site is closed with sutures, which will stay in for about 2 weeks. You can expect some drainage from the site immediately after removal of the catheter, but a bandage (dressing) will be applied. You may need to change your dressing daily.

RISKS

The risks of use of a Hickman catheter include:

  • Infection.

  • Blood clot formation.

  • Uncontrolled bleeding at the site of insertion.

  • The catheter becoming dislodged or clogged to the point that it needs to be replaced.

HOME CARE INSTRUCTIONS

  • Do not participate in sports or any activity that could damage or dislodge your catheter.

  • Avoid bending your joint excessively.

  • Keep your dressing dry.

  • Keep skin near the catheter insertion site dry.

  • Avoid using swimming pools, saunas, and hot tubs.

  • Avoid anything that could make your catheter dirty.

  • Always wash your hands and use gloves before touching the catheter.

  • Make sure the catheter clamp is correctly positioned. This will help prevent a tear in the catheter.

  • Never remove the cap from end of the catheter.

SEEK MEDICAL CARE IF:

  • You see pus, redness, swelling, bleeding, or you feel discomfort around the catheter insertion site.

  • Part of your catheter is pulled out or exposed.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a fever of 102° F (38.9° C).

  • You are unable to stop bleeding from the catheter insertion site.

  • The catheter is dislodged.