+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients

Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients

Annals of Internal Medicine 144(2): 116-126

Background: The efficacy of antimicrobial urinary catheters in hospitalized patients is poorly defined.Purpose: To assess currently marketed antimicrobial urinary catheters for preventing catheter-associated urinary tract infection (UTI).Data Sources: Electronic databases, conference proceedings, bibliographies, trialists, and catheter manufacturers (search dates, 1966 to June 2005).Study Selection: Randomized and quasi-randomized trials of nitrofurazone-coated or silver alloy-coated antimicrobial urinary catheter use for less than 30 days; no language restriction.Data Extraction: Study design, study sample, inclusion and exclusion criteria, allocation, blinding, UTI definition, ascertainment methods, and proportion developing symptomatic UTI (primary end point) or bacteriuria (secondary end point) were extracted by using a structured data collection instrument.Data Synthesis: Twelve qualifying trials (13 392 total participants or catheters) were identified. They compared nitrofurazone-coated silicone (n = 3) or silver-coated latex (n = 9) catheters with silicone or latex catheters. No study addressed symptomatic UTI. All trials suggested protection against bacteriuria with test catheter use. However, effect size varied considerably and postrandomization exclusions were very common. Effect size was greatest in trials of nitrofurazone-coated catheters (all post-1995) and in pre-1995 silver alloy-coated catheter trials and was smallest in post-1995 silver alloy-coated catheter trials. Control group bacteriuria rate, control catheter type (latex vs. silicone), and patient sample (urology vs. other) also predicted effect size. Few studies addressed secondary bloodstream infection, mortality, costs, or microbial resistance. Short-term adverse effects were minimal.Limitations: The study was limited by the number, size, and quality of studies and by lack of the following: intention-to-treat analyses, data on clinical end points, and trials comparing nifrofurazone-coated with silver alloy-coated catheters.Conclusions: According to fair-quality evidence, antimicrobial urinary catheters can prevent bacteriuria in hospitalized patients during short-term catheterization, depending on antimicrobial coating and several other variables. Older data probably lack current relevance. Cost implications and effect on infectious complications remain undefined.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 012614953

Download citation: RISBibTeXText

PMID: 16418411

DOI: 10.7326/0003-4819-144-2-200601170-00009

Related references

Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clinical Infectious Diseases 51(5): 550-560, 2010

Risk factors for catheter-associated urinary tract infection among hospitalized patients: A systematic review and meta-analysis of observational studies. Journal of Advanced Nursing 75(3): 517-527, 2019

Use of silver-hydrogel urinary catheters on the incidence of catheter-associated urinary tract infections in hospitalized patients. American Journal of Infection Control 30(4): 221-225, 2002

Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. Bmj Quality and Safety 23(4): 277-289, 2014

Efficacy of Antimicrobial Catheters for Prevention of Catheter-Associated Urinary Tract Infection in Acute Cerebral Infarction. Journal of Epidemiology 28(1): 54-58, 2018

The clinical and economic effects of silver alloy urinary catheters to prevent urinary tract infection. JGIM 14(Suppl. 2): 68, 1999

Implementing clinical guidelines to prevent catheter-associated urinary tract infections and improve catheter care in nursing homes: Systematic review. American Journal of Infection Control 45(5): 471-476, 2017

The efficacy of noble metal alloy urinary catheters in reducing catheter-associated urinary tract infection. Urology Annals 8(4): 423-429, 2016

Effects of the use of silver-coated urinary catheters on the incidence of catheter-associated bacteriuria and urinary tract infection in dogs. Journal of the American Veterinary Medical Association 253(10): 1289-1293, 2018

A systematic review of the management of short-term indwelling urethral catheters to prevent urinary tract infections. Jbi Library of Systematic Reviews 8(17): 695-729, 2010

Exploring relationships of catheter-associated urinary tract infection and blockage in people with long-term indwelling urinary catheters. Journal of Clinical Nursing 26(17-18): 2558-2571, 2017

Strategies to prevent urinary tract infection from urinary catheter insertion in the emergency department. Journal of Emergency Nursing: Jen 36(6): 546-550, 2010

Evaluating the benefits of antimicrobial prophylaxis to prevent urinary tract infections in children: a systematic review. Cmaj 163(5): 523-529, 2000

Should antibiotics be given on urinary catheter removal to prevent urinary tract infection? A pilot, randomized, double-blind placebo-controlled study. Scandinavian Journal of Urology and Nephrology 37(Suppl 214): 46-47, 2003

Urinary tract infection in non-hospitalized patients with cirrhosis and no symptoms of urinary tract infection: a case series study. Brazilian Journal of Infectious Diseases 10(6): 380-383, 2006