Urinary Catheterisation in Adults - Antimicrobial Prophylaxis During |
Publication: 30/11/2010 |
Next review: 01/05/2026 |
Clinical Guideline |
CURRENT |
ID: 1878 |
Approved By: Improving Antimicrobial Prescribing Group |
Copyright© Leeds Teaching Hospitals NHS Trust 2023 |
This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated. |
Antimicrobial Prophylaxis During Urinary Catheterisation in Adults
Urinary catheters increase the risk of urinary tract infection and sepsis. The risk/benefit of catheterisation varies with the different patient groups. All catheters should be reviewed daily and removed at the earliest opportunity.
Catheters should be removed as soon as they are no longer needed and avoid any unnecessary cathetherisation.
Contact Microbiology to discuss appropriate alternative if the patient has gentamicin resistant organisms and/or allergy.
RECOMMENDED ROUTINE PROPHYLAXIS OPTIONS
ALL PATIENTS: check previous Microbiology results for Gentamicin resistance.
Catheterisation factors |
Patient factors / reason for catheterisation |
Antimicrobial dose/route |
Situations where prophylaxis is needed or should be risk assessed for |
||
Insertion |
Painless (chronic) urinary retention |
Gentamicin 1.5mg/kg IV or IM single dose |
Insertion or removal |
<6 weeks post joint replacement surgery |
|
Removal |
Post prostatic surgery |
|
Removal or change |
Discharge at the exit site or meatus |
|
Change: traumatic |
2 or more attempts required when inserting the new catheter or trauma has occurred (frank haematuria) If catheterisation has failed at the 1st attempt, prophylaxis should be given prior to the next attempt. If prophylaxis was not indicated prior to catheterisation and trauma occurs, give antibiotic dose immediately after catheterisation. |
|
Removal or change |
Long term catheter blockage in a male patient residing in a care home |
|
Removal or change |
MSSA or MRSA isolated from the exit site or meatus in the previous 12 months |
|
Removal or change |
Other patient factors that may increase the risk of developing catheter associated infection are:
Individual risk assessment is advised; where there are 2 or more of these risk factors present prophylaxis is advised. |
|
Insertion |
Pre-operative |
Insert after routine surgical prophylaxis for the procedure being undertaken |
Situations where treatment for infection is required |
||
Removal or change |
Symptomatic UTI |
Treat as per CA-UTI guideline |
Insertion |
Painful (acute) urinary retention: symptomatic UTI |
Treat as per lower UTI guideline (or upper UTI if evidence of urosepsis) |
Situations where prophylaxis is not required |
||
Insertion |
Painful (acute) urinary retention: no symptoms of UTI |
|
Insertion |
Fluid monitoring. |
|
Insertion |
Incontinence |
|
Intermittent self-catheterisation (ISC) |
||
Insertion |
Suprapubic cathether |
|
Insertion, removal or change |
Risk factors for infective endocarditis |
|
Provenance
Record: | 1878 |
Objective: | |
Clinical condition: | |
Target patient group: | Any patient undergoing manipulation (insertion/change/removal) of a urinary catheter |
Target professional group(s): | Secondary Care Doctors Secondary Care Nurses Pharmacists |
Adapted from: |
Evidence base
- NICE infection prevention and control quality standard [QS61], published 17 April 2014
- Urological infections guideline, European Association of Urologists, 2022 update
- Catheterisation Indwelling catheters in adults - Urethral and Suprapubic, European Association of Urology Nurses, 2012
- NICE. Prophylaxis against infective endocarditis: antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. NICE clinical guideline 64: National Institute for Health and Clinical Excellence, 2008. Updated 2016
- NIE. Healthcare-associated infections: prevention and control in primary and community care. Clinical guideline [CG139]. 2012, updated Feb 2017
Approved By
Improving Antimicrobial Prescribing Group
Document history
LHP version 1.0
Related information
Not supplied
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