Suzana Johansson HAL - 2010:16, pp. 53. HAL/Sektionen för hälsa, 2010.
Background: Urinary tract infections caused by indwelling urinary catheters causes unneccesay suffering among those it affects. These infections are also financially straining on the health care services. It is therefore of importance to gain knowledge about which evidence based preventive interventions that have the possibility to reduce the risk for bacteriuria and urinary tract infections among patients with indwelling urinary catheters. Aim: This study aimed to compile available knowledge concerning i) if silver alloy catheters does reduce bacteriuria in this patient group, ii) if aseptic catheterization does reduce bacteriuria in this patientgroup, iii) which routines for changing the urinary drainage bag reduces the risk of bacteriuria, iv) which routine genital hygenic care reduces the risk of bacteriuria? Method: Litterature was searched for in the data bases Cinahl, Medline and The Cochrane Library using the data bases’ thesaurius combined with OR/AND. Fourteen Randomised Controlled Trials (RCT) were included and reviewed using the Consort Statement checklist for Non Pharmacological RCT’s. Cohen’s Kappa showed a high concensus between the two reviewers (0, 85 - 0, 89). Meta-analysis was conducted when ever possible. Result: There are insufficient evidens that silver alloy catheters reduces the risk for bacteriuria when used ≤ 6 days. There is no evidences that aseptic catheterization or that the use of daily antibacterial cleansing agent reduces rates of bacteriuria. No RCT evaluating routines changing the urinary drainage bag was found. Conclusion: The results appear to suggest that the best preventive intervention to reduce the risk for catheter associated bacteriuria is to clean the meatus daily with soap and water. There is not enough scientific evidence to give anyother recommendations in this field. Further research is therefore recommended to find evidence of which preventive interventions can be recommended to reduce the risk for catheter associated urinary tract infections.