Strategies Antimicrobial-Coated Catheters
ÎIn patients with short-term indwelling urethral catheterization, antimicrobial (silver alloy or antibiotic)-coated urinary catheters may be considered to reduce or delay the onset of CA-bacteriuria (B-II).
> Comment: Data are insufficient to make a recommendation about whether use of such catheters reduces CA-UTI in patients with short-term indwelling urethral catheterization or reduces CA-bacteriuria or CA-UTI in patients with long-term catheterization.
Prevention Strategies to Consider After Catheter Insertion Closed Catheter System
ÎA closed catheter drainage system, with ports in the distal catheter for needle aspiration of urine, should be used to reduce CA-bacteriuria (A-II) and CA-UTI (A-III) in patients with short-term indwelling urethral or suprapubic catheters, and to reduce CA-bacteriuria (A-III) and CA- UTI (A-III) in patients with long-term indwelling urethral or suprapubic catheters.
> Institution-specific strategies should be developed to ensure that disconnection of the catheter junction is minimized (A-III) and that the drainage bag and connecting tube are always kept below the level of the bladder (A-III).
ÎUse of a preconnected system (catheter preattached to the tubing of a closed drainage bag) may be considered to reduce CA-bacteriuria (C-II).
> Comment: Data are insufficient to make a recommendation as to whether such a system reduces CA-UTI.
ÎUse of a complex closed drainage system or application of tape at the catheter-drainage tubing junction after catheter insertion is NOT recommended to reduce CA-bacteriuria (A-I) or CA-UTI (A-III).
Prophylaxis
ÎSystemic antimicrobial prophylaxis should NOT be routinely used in short- (A-III) or long-term (A-II) catheterized patients, including surgical patients, to reduce CA-bacteriuria or CA-UTI because of concern about selection of antimicrobial resistance.
ÎMethenamine salts should NOT be used routinely to reduce CA- bacteriuria or CA-UTI in patients on chronic intermittent (A-II) or chronic indwelling urethral or suprapubic (A-III) catheterization.
> Comment: Data are insufficient to make a recommendation about the use of methenamine salts to reduce CA-UTI in patients with using condom catheterization.
ÎMethenamine salts may be considered for the reduction of CA- bacteriuria and CA-UTI in patients following gynecologic surgery who are catheterized for no more than 1 week (C-I). It is reasonable to assume that a similar effect would be seen following other types of surgery.
4
> Comment: Data are insufficient to make recommendations about whether one methenamine salt is superior to another.
