The Catheter Trial

The Catheter Trial: Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial of antibiotic- and antiseptic-impregnated urethral catheters

The study design was a multicentre, randomised controlled trial testing three short-term urinary catheter policies in a range of high-volume clinical settings. The study included adult patients (≥16 years of age) requiring urethral catheterisation (expected to be required for a maximum of two weeks), in pre-selected units with a high volume of short-term catheterisation. There were two experimental groups managed with (a) silver alloy-impregnated hydrogel urethral catheters, (b) nitrofurazone-impregnated silicone urethral catheters. There was one control group managed with a PTFE-coated latex urethral catheter – the ‘standard’ control. The primary clinical outcome was incidence of symptomatic urinary tract infection up to six weeks post-catheter insertion (number of participants with at least one occurrence) and the economic one was incremental cost per infection averted and QALYs gained, using the Euro-Qol 5 Dimensions (EQ–5D) measured over a six-week follow-up period.

Outcome and Translation

This study has helped to inform NHS decision makers and providers whether it is worthwhile for the NHS to use antibiotic- or antiseptic-impregnated urethral catheters in hospitalised adults requiring short-term catheterisation.

HERU researchers involved in this research project: Luke Vale (HERU/HSRU) and Mary Kilonzo

External Collaborators: J N’Dow, A Grant (Division of Applied Health Sciences, University of Aberdeen); J Norrie, K Glazener (HSRU, University of Aberdeen); R Pickard, K Orr (University of Newcastle upon Tyne); B Buckley (Galway); and T Lam (Department of Urology, Aberdeen Royal Infirmary)

The catheter trialThe Academic Urology Unit at the University of Aberdeen has further details of the Catheter Trial project.

Publications

Pickard, R., Lam, T., MacLennan, G., K., S., Kilonzo, M., McPherson, G., Gillies, K., McDonald, A., Walton, K., Buckley, B., Glazener, C., Boachie, C., J Burr, J., Norrie, N., Vale, L., Grant, A. and N'Dow, J. (2011) Types of urethral catheter for reducing symptomatic urinary tract infections ih hopsitalised adults requiring short term catheterisation: a randomised controlled trial. Final report submitted to NIHR Health Technology Assessment Programme, National Institute for Health Research (NIHR).

Pickard, R., Lam, T., MacLennan, G., Starr, K., Kilonzo, M., McPherson, G., Gillies, K., McDonald, A., Walton, K., Buckley, B., Glazener, C., Boachie, C., Burr, J., Norrie, J., Vale, L., Grant, A. and N'Dow, J. (2012) 'Antimicrobial catheters for reduction of symptomatic urinary tract infection in adults requiring short-term catheterisation in hospital: a multicentre randomised controlled trial', The Lancet, 380(9857), 1927-1935.

Pickard, Lam, T., Maclennan, G., Starr, K., Kilonzo, M., McPherson, G., Gillies, K., McDonald, A., Walton, K., Buckley, B., Glazener, C., Boachie, C., Burr, J., Norrie, J., Vale, L., Grant, A. and N'Dow, J. (2012) ‘Types of urethral catheter for reducing symptomatic urinary tract infections in hospitalised adults requiring short-term catheterisation: multicentre randomised controlled trial and economic evaluation of antimicrobial- and antiseptic-impregnated urethral catheters (the CATHETER trial),’ Health Technology Assessment, 16(47).

Kilonzo, M., Vale, L., Pickard, R., Lam, T. and N’Dow, J. (2014) 'Cost effectiveness of antimicrobial catheters for adults requiring short-term catheterisation in hospital', European Urology, 66(4), 615-618.

Kilonzo, M. (2015) 'Reducing hospital infections: which catheter?', HERU Policy Brief, University of Aberdeen, December 2015.