The number of patients in hospitals and rehabilitation institutions at any time is large, and a considerable number of them need to use a urinary catheter. Catheter-associated urinary tract infection may affect a large number of persons. The survey of prevalence of May 2015 from the Norwegian Institute of Public Health reported that 1.2 percent of patients in hospitals suffered from a urinary tract infection. We have systematically reviewed research on effect of interventions to prevent catheter-associated urinary tract infection.

We identified seven systematic reviews of high methodological quality published in the Cochrane Database of Systematic Reviews after 2010, i.e. after the Patient Safety Campaign started. The reviews intended to review the effect of 41 different interventions. Only 15 interventions were studied, and five of these studies included less than 25 participants. When the intervention is only evaluated in one study, and with few participants, we have little confidence in the effect estimate. Most studies were published between 1979 and 1997; only four studies were published after 2010. One of these studies found that among patients who had antibiotic impregnated catheters, there was a small reduction in the incidence of catheter-associated urinary tract infection. Whether this effect is clinically significant is unclear. We do not have sufficient documentation for other interventions intended to prevent catheter-related urinary tract infection.

Several of the studies evaluated the effect of antibiotics, and even though antibiotics seem to prevent infections, the studies included very few participants or had methodological weaknesses that contribute to our very low confidence in the effect estimates. The Norwegian national guidelines for prevention of catheter-associated urinary tract infection recommends that catheters impregnated with antibiotics should not be the first choice in Norwegian hospitals. Our report did not find evaluations of long term effects of antiseptic or antibiotic agents for preventing catheter-associated urinary tract infections. Antibiotic resistant bacteria is a problem, in Norway as well as internationally. This is important to keep in mind when applying these results.

There is a need for research about prevention of catheter-related urinary tract infection.