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Intensive Care Medicine

, Volume 33, Issue 4, pp 726–729 | Cite as

A randomized trial of catheter change and short course of antibiotics for asymptomatic bacteriuria in catheterized ICU patients

  • Marc LeoneEmail author
  • Anne-Sophie Perrin
  • Isabelle Granier
  • Pierre Visintini
  • Valery Blasco
  • François Antonini
  • Jacques Albanèse
  • Claude Martin
Brief Report

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.

Keywords

Bacteriuria Intensive care unit Urinary catheter Antibiotics 

Supplementary material

134_2007_534_MOESM1_ESM.doc (32 kb)
Electronic Supplementary Material (DOC 32K)

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Marc Leone
    • 1
    Email author
  • Anne-Sophie Perrin
    • 1
  • Isabelle Granier
    • 2
  • Pierre Visintini
    • 1
  • Valery Blasco
    • 1
  • François Antonini
    • 1
  • Jacques Albanèse
    • 1
  • Claude Martin
    • 1
  1. 1.Département d’Anesthésie et de RéanimationAssistance Publique Hôpitaux de Marseille, CHU NordMarseille cedex 20France
  2. 2.Service de Réanimation PolyvalenteCentre Hospitalier Intercommunal de ToulonToulonFrance

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