Approximately 25% of patients admitted to hospital will require urethral catheterisation at some stage during their stay. Catheter-associated symptomatic urinary tract infections (CAUTI) are the leading cause of hospital acquired infections, accounting for between 23% and 40% of all cases. Such infections result in additional morbidity and mortality and represent a considerable economic burden to the health care sector, patients and their carers.
The CATHETER Trial was a multicentre UK trial which aimed to establish the clinical benefits and cost-effectiveness of using antibiotic- (nitrofurazone) or antiseptic- (silver) impregnated urethral catheters over standard urethral catheters in hospitalised adults requiring short term (≤ 14 days) catheterisation. The trial recruited 7102 participants from 24 UK centres.
The study concluded that silver alloy-coated catheters are unlikely to be effective at reducing CAUTI. Nitrofurazone catheters were also ineffective against CAUTI, but did show some antimicrobial activity for secondary bacteriological outcomes. However, any benefit may be offset by increased discomfort from their use and concerns regarding indiscriminate antimicrobial use.
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. & 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, vol 380, no. 9857, pp. 1927-1935.
Pickard, R., Lam, T., Maclennan, G., Starr, K., Kilonzo, M., McPherson, GC., Gillies, K., McDonald, AM., Walton, K., Buckley, B., Glazener, CMA., Boachie, C., Burr, J., Norrie, JDT., Vale, L., Grant, A. & 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, vol 16, no. 47, pp. 1-197.