Long-term urinary catheter-associated urinary tract infection (UTI)
Dr Miriam Paul
This paper reviews the literature on the current management of symptomatic urinary tract infections (UTIs) in those with long-term urinary catheters. Long-term is defined as being in situ for more than 1 month. The discussion refers to published guidelines and relevant clinical trials. As bacteriuria is universal in people with long-term urinary catheters, diagnosis of symptomatic UTIs is made chiefly by the presence of clinical symptoms, which usually include fever. Urine culture is then performed in order to direct an appropriate antibiotic choice. Urinary catheter change at the time of initiating treatment is likely to lead to earlier clinical improvement, and a more accurate assessment of infecting organisms when a culture is taken via the new catheter. Antibiotic treatment should be for as short a time as possible, 5-7 days, to reduce the selection of resistant microorganisms. Regular catheter change and newer catheter materials have not been proven to reduce the incidence of symptomatic UTIs in those with a long-term urinary catheter in situ.