The importance of central venous catheter removal in patients with candidaemia: time to rethink our practice?

The issue of central venous catheter (CVC) removal in adult patients with candidaemia remains controversial. Although removal of CVCs has been advocated as an adjunctive strategy for treating patients with candidaemia, most studies have failed to control for important variables, e.g., the severity of illness and persistence of neutropenia. Multivariate analysis has failed to identify a significant effect of CVC removal on the prognosis for patients with candidaemia. A properly designed randomised trial that controls for confounding variables is necessary to clarify the importance of CVC removal in such patients. Until this evidence is available, systematic removal of all CVCs in these patients seems not to be justified.