Scripties UMCG - Rijksuniversiteit Groningen
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The clinical effect of early urinary catheter replacement among adults with urinary tract infection

(2019) Bavinck, P. (Pavien)

Introduction: Having a long term indwelling catheter increases the risk of developing catheter related complications, like urinary tract infection (UTI) or urosepsis. While the purpose of catheter replacement in the case of an UTI is generally accepted, there is no consensus about the optimal moment to replace the catheter. We determined if early catheter replacement of a chronic indwelling catheter leads to improved clinical outcomes compared to delayed replacement when treating urosepsis in hospitalized patients. Material & Method: This retrospective cohort study was conducted in the internal medicine department at Deventer Hospital. Data were obtained from the medical records of patients, who were diagnosed with catheter associated urinary tract infection and admitted during the period from 01/2014 to 10/2018. The moment of catheter replacement was used as continuous measurement and as interval dividing an early replacement group (0-2 days) and late replacement group (>2 days). The primary endpoint was duration of fever, secondary endpoints were length of admission and incidence of relapse.
Results: Enrolled in our study were a total of 54 patients with a mean age of 77, 25 patients into the early replacement group and 29 patients in the late replacement group. No associations were observed between moment of catheter replacement and duration of fever or the incidence of relapse. We found a significant shorter length in the period of stay with earliest catheter replacement compared to the patients with latest catheter replacement.
Discussion and conclusion: There is no indication to assume a clinically negative effect of early catheter replacement comparing to later replacement nor is there enough evidence to assume a positive effect of early replacement.

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