The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterisation: A systematic review
Abstract
OBJECTIVE
This systematic review had two aims. First to identify the incidence of urinary tract infection (UTI) and bacteriuria in people undertaking intermittent catheterisation (IC), second to determine the effectiveness of antiseptic cleaning of the meatal area prior to IC in reducing the incidence of UTI and bacteriuria.
DESIGN
A systematic review was conducted.
METHODS
Medline and the Cumulative Index to Nursing and Allied Health Literature electronic databases were systematically searched between 1st January 1990 and 31st January 2020, to identify studies that reported either the incidence of UTI or bacteriuria or the impact of using antiseptics for meatal cleaning prior to IC on incidence of these same outcomes.
RESULTS
Twenty-five articles were identified for the first aim, two articles for the second. The proportion of participants experiencing ≥1 UTIs per year ranged from 15.4% to 86.6%. Synthesis of these studies suggest a combined incidence of 44.2% [95%CI 40.2-48.5%] of participants having ≥1 UTIs per year. One of the two studies exploring the benefit of antiseptics in reducing UTI suggest some potential benefit of using chlorhexidine in reducing UTIs. Both studies have significant limitations, making interpretation difficult.
CONCLUSION
A large proportion of people undertaking IC in the community have UTIs each year. Evidence on the role of antiseptics in the prevention of UTI for people who undertake IC remains unclear.
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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