A randomized trial of catheter change and short course of antibiotics for asymptomatic bacteriuria in catheterized ICU patients |
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Authors: | Marc Leone Anne-Sophie Perrin Isabelle Granier Pierre Visintini Valery Blasco François Antonini Jacques Albanèse Claude Martin |
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Institution: | 1.Département d’Anesthésie et de Réanimation,Assistance Publique H?pitaux de Marseille, CHU Nord,Marseille cedex 20,France;2.Service de Réanimation Polyvalente,Centre Hospitalier Intercommunal de Toulon,Toulon,France |
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Abstract: | Objective To determine the effect on the occurrence of urosepsis of a treatment with a short course of antibiotics and indwelling urethral
catheter replacement in clinically asymptomatic intensive care unit (ICU) patients with a positive urine culture occurring
at least 48 h after catheterization.
Methods A prospective randomized clinical trial was conducted in the medico-surgical ICU of a tertiary care centre. Sixty patients
hospitalized in the ICU with an indwelling urethral catheter for longer than 48 h developing an asymptomatic positive urine
culture were randomized to receive either a 3-day course of antibiotics associated with the replacement of the indwelling
urethral catheter 4 h after first antibiotic administration or no antibiotics, no catheter replacement (standard of care).
Results Three patients in each group developed urosepsis (P = 0.1). There were no significant differences in duration of mechanical ventilation between the study group and the standard
of care group (9 4–20] days vs 5 2–15] days, P = 0.2), in duration of urinary catheterization (22 11–40] days vs 18 14–33] days, P = 0.8), or in length of ICU stay (28 13–46] vs 19 15–34], P = 0.6). The recurrence of positive urine culture at days 7 and 15 was not affected by the randomization (P = 0.1). The profile of bacterial resistance was similar in the two groups.
Conclusions Treating a positive urine culture in an asymptomatic patient with an indwelling urethral catheter does not reduce the occurrence
of urosepsis in the medico-surgical ICU.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users
Conflict of interest: none
Financial support: none |
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Keywords: | Bacteriuria Intensive care unit Urinary catheter Antibiotics |
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