Catheter UTI

Micro-organism

Escherichia coli,

other intestinal aerobes

Advice

Bacterial colonisation of long term indwelling catheters is very common.

Antimicrobial therapy is not indicated unless the patient has evidence of systemic infection e.g. pyrexia, loin pain, raised white cell count or acute confusion in the elderly. 

Smelly or cloudy urine, bacteriuria without systemic symptoms, or catheter blockage are not indications for antimicrobials.

If systemic infection is likely, treat as for complicated UTI or pyelonephritis depending on clinical symptoms.

Take urine sample (and blood culture if pyrexial) and commence antibiotic therapy (consider previous microbiology sensitivity results if available).

Remove and replace urinary catheter (if still required) following 1st or 2nd dose of antibiotics.