What is the recommended treatment for a catheter-related tunnel infection?

• A. Local topical antibiotics only
• B. Oral analgesics and watchful waiting
• C. Systemic antibiotics and possible catheter removal
• D. Increase dialysis exchange frequency

Answer: (C)

Tunnel infection involves the tissue along the catheter path, not just the skin exit. Because the infection is in deeper tissues, topical treatments or just watching and waiting won’t eradicate it. The appropriate approach is systemic antibiotics to reach the infected tissue and cover common skin-colonizing and Gram-negative organisms. In many cases, the catheter may need to be removed if the infection does not improve quickly or if there are signs of a tunnel abscess or systemic illness. Increasing dialysis exchange frequency wouldn’t treat the infection itself and could even risk spreading bacteria. So the best path is systemic antibiotics with the possibility of catheter removal if the infection doesn’t respond or is severe.