> If the catheter can be discontinued, a voided midstream urine culture should be obtained prior to the initiation of antimicrobial therapy to help guide treatment (A-III).
Duration of Treatment
ÎSeven days is the recommended duration of antimicrobial treatment for patients with CA-UTI who have prompt resolution of symptoms (A-III), and 10 to 14 days is recommended in those with a delayed response (A-III), regardless of whether the patient remains catheterized or not.
> A 5-day regimen of levofloxacin may be considered in patients with CA-UTI who are not severely ill (B-III). Data are insufficient to make such a recommendation about other fluoroquinolones.
> A 3-day antimicrobial regimen may be considered for women age 65 or younger who develop CA-UTI without upper tract symptoms after an indwelling catheter has been removed (B-II).
Consider condom (in men), intermittent and suprapubic catheterization as alternates
Urinary Catheters Careful screening:
technique is more important in institutional than in community settings
If urethral catheter is indicated: Aseptic Maintain integrity of closed system Remove as soon as possible
If ASB in women ≥ 48 hours aſter removal
Consider treatment If UTI
Replace catheter aſter 2 weeks if still needed
If ASB
Treatment not indicated
Obtain C&S from new catheter or voided midstream specimen
(Consider 5 days of levof loxacin) Consider 3 days for women ≤ 65 without upper tract symptoms)
Treat for 7-14 days 7
