Editorials

Should antibiotic prophylaxis after urinary catheter removal be standard practice?

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3938 (Published 21 June 2013) Cite this as: BMJ 2013;346:f3938
  1. Manisha Juthani-Mehta, associate professor of medicine
  1. 1Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, PO Box 208022, New Haven, CT 06520, USA
  1. manisha.juthani{at}yale.edu

Could be considered for patients who have had urological procedures but not for all

For patients in hospital, catheter-associated urinary tract infection (CAUTI) is common and preventable. The most effective strategies for reducing such infections are to limit catheter insertion or promptly remove catheters when they are no longer indicated. Automatic stop orders have been used to reduce unnecessary catheterisations.1 Nitrofurazone coated catheters could reduce the rate of CAUTI and be cost effective in the United Kingdom’s health system,2 3 4 but current international guidelines do not recommend the routine use of prophylactic antibiotics to prevent CAUTI at the time of catheter removal.5

The linked paper by Marschall and colleagues (doi:10.1136/bmj.f3147) is a meta-analysis of antibiotic prophylaxis for CAUTI prevention after urinary catheter removal.6 This meta-analysis evaluated data from six randomised controlled trials (five published, one unpublished) and one comparative study of two urologists’ practices. Overall, patients receiving antibiotics had an absolute reduction in CAUTI of 5.8%, and 17 patients were needed to receive antibiotics to prevent one CAUTI. …

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