Phlebitis is one of the most prevalent side effects of intravenous catheter insertion (Lanbeck et al., 2004, Malach et al., 2006). Inflammation of intima (the innermost layer of veins) with a red skin appearance along with stiff and painful veins around the catheterization site is the most common sign of phlebitis, which may last from several days to several weeks (de Campos Pereira and Zanetti, 2000). Phlebitis can cause clot formation, thrombophlebitis, and embolism (Potter & Perry, 2013). Phlebitis causes an increased risk of infections and treatment costs; also, it can postpone the administration of medications, wasting the nurses' time, and prolonging the hospitalization period (Avazeh et al., 2005).

The prevalence of phlebitis in different regions of the world is estimated to be 7% to 44% (Atay et al., 2018, Rickard et al., 2012, Simin et al., 2019, Wallis et al., 2014). Phlebitis is caused by peripheral catheter insertion; and can cause bacterial colonization and lead to a blood infection (Redelmeier & Livesley, 1999). The rate of mortality related to infection due to catheterization is reported up to 25% (Musarezaie et al., 2013). Maki et al. showed that in America, every year more than 25 thousand patients get bacteremia related to intravenous catheterization (Maki et al., 2006).

Phlebitis can also be related to improper catheterization technique, duration of using a catheter, patient's clinical condition, drug incompatibility, drug or solution pH, and characteristics of selected vein including its diameter, size, and, length (Mohammadzadeh et al., 2007). Some of the above-mentioned risk factors for phlebitis were related to the medications administered via the catheter. The term “chemical phlebitis” is a type of phlebitis, which is usually related to the administration of medications. The concentration of drugs, rapid injection, or the presence of small particles in the solution can increase the chemical phlebitis risk (Martinho & Rodrigues, 2008). Nurses have reported high rates of phlebitis related to amiodarone injections even when hospital guidelines are followed (Mowry and Hartman, 2011, Silva et al., 2012). Amiodarone is an antiarrhythmic agent and a Benzofuran derivative (Bronstein, 1998, Terra Filho, 1998). Amiodarone-induced phlebitis (AIP) prevalence is reported at 5%-85% in different studies (Cheewatanakornkul et al., 2022). Rodrigues and Martinho reported that phlebitis prevalence among patients receiving intravenous amiodarone is 55% especially those who were over 65 years old, those who received not diluted amiodarone, and insufficient nursing care (Martinho & Rodrigues, 2008). The possible explanation for amiodarone-induced phlebitis (AIP) is that amiodarone crystallizes after infusion and these needle-shaped crystals injure the endothelium (Oragano et al., 2019).

Studies have shown the positive effects of applying herbal and therapeutical creams and oils for reducing and preventing phlebitis, including the use of nitroglycerin ointment (Kazemi et al., 1996) and sesame oil (N Nekozad et al., 2010).

One of the anti-inflammatory substances recently used widely is propolis (Velazquez et al., 2007). Propolis is anti-inflammatory, antioxidant, anti-pathogenic, anti-tumor, immune regulatory, and has beneficial advantages for burned skin and also has liver protection properties (Bankova, 2005, Banskota et al., 2001, da Rosa et al., 2022). Propolis inhibits the synthesis of prostaglandin and helps the immune system by increasing the activity of phagocytosis and stimulating cellular immunity and helping epithelial tissue to heal faster (Özan et al., 2007). Due to its anti-inflammatory properties (Özan et al., 2007) and also its antimicrobial effects. Many previous studies examined the honey and propolis cream on pressure ulcer but few studies examined its effect on phlebitis (Sforcin et al., 2000). we investigated the effect of propolis cream on phlebitis and catheter-related bloodstream infections related to amiodarone administration.