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

This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

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 Give within 1 hour before catheter manipulation
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: Severe immunosuppression, Male sex, Abnormal urinary tract Multiple co-morbidities 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. Remove at the earliest opportunity
Insertion	Incontinence Catheters should not be routinely used for incontinence management
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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