There is conflicting evidence and hence variation in practice, on which solution you should use for meatal cleaning prior to urinary catheter insertion. A systematic review demonstrates the variation in evidence.
Which do you use in your hospital or clinical practice?
You can vote using the poll below. The results will form part of the discussion in a talk at the IPS conference and ACIPC conference.
So, which is correct?
Well, we will soon be able to tell you whether chlorhexidine or saline is better (or no difference) at reducing CAUTI and asymptomatic bacteriuria. We have undertaken a RCT in three hospitals, involving hundreds of patients and catheter insertions. The aim is to determine the effectiveness and cost effectiveness of chlorhexidine vs saline. The outcomes are asymptomatic bacteriuria and CAUTI.
Data collection was completed earlier this year and analysis is also nearing completion.
I would like to thank the participating hospitals – Canberra hospital, Sydney Adventist Hospital and Lismore hospital.
More to come on this, so stay tuned. The results, regardless of what they are, will help shape guidelines and clinical practice internationally.
Researcher team: Prof Brett Mitchell, Dr Oyebola Fasugba, Dr Anne Gardner, Dr Jane Koerner, Prof Peter Collignon, Prof Allen Cheng, Prof Nick Graves, Mrs Vicky Gregory (Project Manager)
Funding: This project is supported a grant from the HCF Foundation, a nationally competitive grant.
Fasugba, O., Koerner, J., Mitchell, B. G., & Gardner, A. (2017). Systematic review and meta-analysis of the effectiveness of antiseptic agents for meatal cleaning in the prevention of catheter-associated urinary tract infections. Journal of Hospital Infection, 95(3), 233-242.
Mitchell, B. G., Fasugba, O., Gardner, A., Koerner, J., Collignon, P., Cheng, A. C., … & Gregory, V. (2017). Reducing catheter-associated urinary tract infections in hospitals: study protocol for a multi-site randomised controlled study. BMJ open, 7(11), e018871.