Measuring the efficacy of antimicrobial catheters

Catheter-associated urinary tract infections (CAUTI) are a major cause of morbidity in hospitals worldwide. Urethral catheters coated with antimicrobial substances such as silver alloy and nitrofurazone were introduced to reduce CAUTI. A previous Cochrane review reported that antimicrobial-coated or impregnated catheters may reduce the number of asymptomatic bacteriuria present but it was uncertain whether they reduced CAUTI. The Catheter Trial compared these and standard catheters for short-term use in NHS hospitals. Results showed silver alloy-coated catheters did not reduce symptomatic CAUTI compared with standard catheters; nitrofurazone-impregnated catheters had borderline clinical benefit in reducing symptomatic CAUTI. The findings do not support the routine use of antimicrobial-coated or impregnated catheters for patients in hospital who need short-term catheters. Instead, health professionals should focus on simple preventive strategies and reducing the need for catheterisation.