Urinary catheters and nosocomial infection.

Latex catheters appear to be associated with a higher incidence of complications than silicone or Silastic tubing. Patients with indwelling catheters in whom asymptomatic bacteriuria develop usually do not require treatment until the time of catheter removal. In symptomatic patients, however, samples of blood and urine should be obtained for culture and sensitivity testing. Empiric therapy with parenteral antibiotics--such as an aminoglycoside plus ampicillin or piperacillin--should then be initiated. To reduce infectious complications associated with the use of urinary catheters, clinicians should always carefully determine whether or not a true indication for catheterization exists. In addition, intermittent bladder catheterization and suprapubic drainage should be considered whenever appropriate. Specific guidelines for preventing infection or superinfection in patients with indwelling catheters are provided.