What are the IDSA guidelines for reduction in the use of catheterization in order to prevent catheter-associated urinary tract infections (CAUTIs) in men?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

According to the IDSA 2009 guideline for the diagnosis, prevention, and treatment of CAUTI in adults, if an indwelling catheter has been in place for more than 2 weeks at the onset of CAUTI and remains indicated, the catheter should be replaced to promote continued resolution of symptoms and to reduce the risk of subsequent catheter-associated infection. [24]

The guideline also states that an indwelling catheter may be considered at the patient’s request in exceptional cases and when other approaches to management of incontinence have proven ineffective. [24]

According to the IDSA guideline, strategies to reduce the use of catheterization have been proven effective and may have more impact on the incidence of CAUTI and asymptomatic bacteriuria than other approaches addressed in the guidelines. [24]

The CDC 2009 guideline for the prevention of CAUTI states that catheter use and duration should be minimized in all patients, especially those at higher risk for CAUTI (women, elderly persons, patients with impaired immunity). [25] The CDC guideline recommends the following preventive measures [25] :

  • Catheters should be used only for appropriate indications

  • Catheters should be kept in place only for as long as needed

  • Indwelling catheters in operative patients should be removed as soon as possible postoperatively

  • Use of urinary catheters for treatment of incontinence should be avoided in patients and nursing home residents

Appropriate indications for indwelling urethral catheters include the relief of bladder outlet obstruction, treatment of urinary incontinence in a patient with an open sacral wound, and monitoring of urine output; they are also indicated for use during prolonged surgical procedures.


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