Preventing catheter-related bacteriuria - Should we? Can we? How?

Up to 25% of hospitalized patients undergo urinary catheterization, and abo ut 5% develop bacteriuria each day of catheterization, Catheter-related bac teriuria is associated with increased morbidity and mortality. We performed an evidence-based synthesis of the literature on preventing catheter-assoc iated urinary tract infections (UTIs) to develop recommendations for clinic ians. Catheterization should be avoided when not required and when needed, should be terminated as soon as possible. Use of suprapubic and condom cath eters may be associated with a lower risk of UTI than use of urethral cathe ters, Aseptic catheter insertion and a properly maintained closed drainage system are crucial to reducing the risk of bacteriuria, Instillation of ant imicrobial agents into the bladder or urinary drainage bag and rigorous mea tal cleansing seem to be of little benefit. Use of urinary catheters coated with silver alloy may reduce the risk of UTI, Systemic antimicrobial drug therapy seems to prevent UTIs, but primarily for patients catheterized for 3 to 14 days. Antibiotic drug prophylaxis is especially valuable in patient s undergoing transurethral resection of the prostate or renal transplantati on. Using these methods, urinary catheter-associated UTI can often be preve nted for weeks, but not longer terms.