ÎWhen using a methenamine salt to reduce CA-UTI, the urinary pH should be maintained below 6.0 (B-III).
> Comment: Data are insufficient to recommend how best to achieve a low urinary pH.
ÎCranberry products should NOT be used routinely to reduce CA- bacteriuria or CA-UTI in patients with neurogenic bladders managed with intermittent or indwelling catheterization (A-II).
> Comment: Data are insufficient to make a recommendation on the use of cranberry products to reduce CA-bacteriuria or CA-UTI in other groups of catheterized patients, including those using condom catheters.
Enhanced Meatal Care
ÎDaily meatal cleansing with povidone-iodine solution, silver sulfadiazine, polyantibiotic ointment or cream, or green soap and water is NOT recommended for routine use in men or women with indwelling urethral catheters to reduce CA-bacteriuria (A-I).
> Comment: Data are insufficient to make a recommendation as to whether meatal cleansing reduces the risk of CA-UTI.
Catheter Irrigation
ÎCatheter irrigation with antimicrobials should NOT be used routinely to reduce or eradicate CA-bacteriuria (A-I) or CA-UTI (A-II) in patients with indwelling catheters.
ÎCatheter irrigation with antimicrobials may be considered in selected surgery patients undergoing short-term catheterization to reduce CA-bacteriuria (C-I).
> Comment: Data are insufficient to make a recommendation about whether bladder irrigation in such patients reduces CA-UTI.
ÎCatheter irrigation with normal saline should NOT be used routinely to reduce CA-bacteriuria, CA-UTI or obstruction in patients on long-term indwelling catheterization (B-II).
Antimicrobials in the Drainage Bag
ÎRoutine addition of antimicrobials or antiseptics to the drainage bag of catheterized patients should NOT be used to reduce CA-bacteriuria (A-I) or CA-UTI (A-I).
Routine Catheter Change
ÎData are insufficient to make a recommendation as to whether routine catheter change, such as every two to four weeks, in patients with functional long-term indwelling urethral or suprapubic catheters reduces the risk of CA-ASB or CA-UTI, even in patients who experience repeated early catheter blockage from encrustation.
5
