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- Title
A randomized trial of catheter change and short course of antibiotics for asymptomatic bacteriuria in catheterized ICU patients.
- Authors
Leone, Marc; Perrin, Anne-Sophie; Granier, Isabelle; Visintini, Pierre; Blasco, Valery; Antonini, François; Albanèse, Jacques; Martin, Claude; Antonini, François; Albanèse, Jacques
- Abstract
<bold>Objective: </bold>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.<bold>Methods: </bold>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).<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
SEPTICEMIA treatment; CATHETERS; ANTIBIOTICS; INTENSIVE care units; CLINICAL trials; ARTIFICIAL respiration; COMPARATIVE studies; LENGTH of stay in hospitals; RESEARCH methodology; MEDICAL cooperation; RESEARCH; STATISTICAL sampling; URINARY catheterization; EVALUATION research; RANDOMIZED controlled trials; BACTERIURIA; HOSPITAL mortality
- Publication
Intensive Care Medicine, 2007, Vol 33, Issue 4, p726
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-007-0534-1