Future microbiology · 2026
Empirical antibiotic use in nonsurgical patients with indwelling urinary catheters: a systematic review.
Систематический обзорСтатьяНазвание и аннотация: Перевод в очереди
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Felsypremila Gnanasekaran, Kumaraguru Mahalakshmi, Geminiganesan Sangeetha, Saikia Ankita, Nirmal Latha, Boopalan Deenadayalan, Sridharan Shreya, Muthu M S
Аннотация
AIM: This systematic review aimed to assess the effect of empirical antibiotics in comparison with no antibiotics or alternative regimens on the prevention/resolution of catheter-associated urinary tract infection (UTIs) and catheter-associated asymptomatic bacteriuria among nonsurgical patients with indwelling urinary catheters (IUCs).
MATERIALS AND METHODS: A literature search was performed across five databases. Evidence synthesis adhered to the Synthesis Without Meta-analysis guidelines (SWiM).
RESULTS: Four studies involving 4,907 participants were analyzed. The bacteriological resolution of catheter-associated UTIs varied, showing no significant difference between the treated group (meropenem) and the untreated group (p > 0.05), and achieving up to 53.6% clearance with fosfomycin. Significantly, the rate of repeat positive urine cultures differed between the antibiotic groups (p = 0.000), with the highest recurrence in the fosfomycin group. Two studies examining clinical outcomes reported no significant differences between the antibiotic groups.
CONCLUSION: The overall direction of effect indicated either no significant difference between antibiotic groups or outcomes favoring non-carbapenem therapy. The evidence remains insufficient for definitive conclusions on the effect of empirical antibiotic therapy on the resolution of catheter-associated infection among persons with IUC.
PROSPERO PROTOCOL REGISTRATION: https://www.crd.york.ac.uk/prospero/ identifier is CRD420251062752.
MATERIALS AND METHODS: A literature search was performed across five databases. Evidence synthesis adhered to the Synthesis Without Meta-analysis guidelines (SWiM).
RESULTS: Four studies involving 4,907 participants were analyzed. The bacteriological resolution of catheter-associated UTIs varied, showing no significant difference between the treated group (meropenem) and the untreated group (p > 0.05), and achieving up to 53.6% clearance with fosfomycin. Significantly, the rate of repeat positive urine cultures differed between the antibiotic groups (p = 0.000), with the highest recurrence in the fosfomycin group. Two studies examining clinical outcomes reported no significant differences between the antibiotic groups.
CONCLUSION: The overall direction of effect indicated either no significant difference between antibiotic groups or outcomes favoring non-carbapenem therapy. The evidence remains insufficient for definitive conclusions on the effect of empirical antibiotic therapy on the resolution of catheter-associated infection among persons with IUC.
PROSPERO PROTOCOL REGISTRATION: https://www.crd.york.ac.uk/prospero/ identifier is CRD420251062752.