Antibiotic Irrigation and Catheter-Associated Urinary-Tract Infections

TLDR

To evaluate whether antibiotic irrigation prevents catheter‑associated urinary‑tract infections, the authors conducted a randomized controlled trial using a neomycin‑polymyxin irrigant delivered through closed urinary catheters. The trial employed a parallel‑group design with 98 patients receiving no irrigation and 89 patients receiving the irrigant, with outcomes measured as daily infection incidence and organism characteristics. Infection rates were similar (18 % vs 16 %) but irrigation was linked to a higher frequency of catheter junction disconnections and a shift toward more resistant organisms, resulting in comparable overall infection rates.

Abstract

To investigate the efficacy of antibiotic irrigation in preventing catheter-associated urinarytract infection, we carried out a randomized controlled trial of a neomycin-polymyxin irrigant administered through closed urinary catheters. Eighteen of 98 (18 per cent) of the patients not given irrigation became infected, as compared with 14 of 89 (16 per cent) of those given irrigation, yielding a mean daily incidence of 5 per cent in each group. The distribution of organisms and their antibiotic sensitivities differed in the two groups, the organisms from the patients with irrigation being more resistant. Disconnections of the catheter junctions were associated with high rates of infection. The rate of disconnections of the junctions in the group given irrigation was almost twice that of the control group because of the presence of the extra junction on overall infection rate represents the result of two opposing phenomena: the increased entry of organisms and the suppression of a portion of them.