Do prophylactic catheter washouts reduce catheter associated urinary tract infections and catheter blockage compared to standard care in adults living with long-term catheters? A systematic review with meta-analysis
Abstract
INTRODUCTION
Prophylactic catheter washouts (PCWs) are often recommended to patients with long-term catheters (LTCs) to reduce symptomatic catheter-associated urinary tract infection (S-CAUTI) and catheter blockage. This systematic review summarizes current evidence on the benefits and harms of regular PCWs for adults using LTCs.
METHODS
A literature search was conducted using MEDLINE, EMBASE, CINAHL, and CENTRAL (database inception to June 2024) for randomized controlled trials (RCTs) and quasi-RCTs comparing PCWs to standard care, or different catheter washout solutions to each other. The review followed Cochrane Handbook methodology. Certainty of evidence was assessed using GRADE. Detailed protocol registered with PROSPERO (CRD42024553575).
RESULTS
Seven RCTs were included. The review found lower S-CAUTI rates in saline washout groups (SWGs) than no washout groups (NWGs) (mean difference [MD] -0.10, 95% confidence interval [CI] -0.50-0.29; low certainty evidence; p=0.61) and lower S-CAUTI rates in any washout groups (WG) compared to NWGs (MD -0.05, 95% CI -0.42-0.32; low certainty evidence; p=0.79). The review found reduced odds of catheter blockage in acidic washout groups (AWGs) than SWGs (odds ratio [OR] 0.51, 95% CI 0.25-1.03; very low certainty evidence; p=0.06). Airaksinen 1979 also found increased odds of greater encrustation in their NWG compared to their SWG (OR 0.62, 95% CI 0.17-2.25; very low certainty evidence; p=0.46). The review found that WGs had reduced…
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