Coated urethral catheters were introduced in clinical practice to reduce the risk of catheter-acquired urinary tract infection (CAUTI). We aimed to systematically review the incidence of CAUTI and adverse effects in randomized clinical trials of patients requiring indwelling bladder catheterization by comparing coated vs. non-coated catheters. This review was performed according to the 2020 PRISMA framework. The incidence of CAUTI and catheter-related adverse events was evaluated using the Cochran-Mantel-Haenszel method with a random-effects model and reported as the risk ratio (RR), 95% CI, and p-values. Significance was set at p < 0.05 and a 95% CI. Twelve studies including 36,783 patients were included for meta-analysis. There was no significant difference in the CAUTI rate between coated and non-coated catheters (RR 0.87 95% CI 0.75-1.00, p = 0.06). Subgroup analysis demonstrated that the risk of CAUTI was significantly lower in the coated group compared with the non-coated group among patients requiring long-term catheterization (>14 days) (RR 0.82 95% CI 0.68-0.99, p = 0.04). There was no difference between the two groups in the incidence of the need for catheter exchange or the incidence of lower urinary tract symptoms after catheter removal. The benefit of coated catheters in reducing CAUTI risk among patients requiring long-term catheterization should be balanced against the increased direct costs to health care systems when compared to non-coated catheters.
Journal of clinical medicine. 2022 Jul 30*** epublish ***
Vineet Gauhar, Daniele Castellani, Jeremy Yuen-Chun Teoh, Carlotta Nedbal, Giuseppe Chiacchio, Andrew T Gabrielson, Flavio Lobo Heldwein, Marcelo Langer Wroclawski, Jean de la Rosette, Rodrigo Donalisio da Silva, Andrea Benedetto Galosi, Bhaskar Kumar Somani
Department of Urology, Ng Teng Fong General Hospital (NUHS), Singapore 609606, Singapore., Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, 60126 Ancona, Italy., S.H.Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China., Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA., Department of Urology, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brazil., Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil., Department of Urology, Medipol Mega University Hospital, Istanbul Medipol University, 34214 Istanbul, Turkey., Division of Urology, Denver Health Medical Center, University of Colorado, Denver, CO 80204, USA., Department of Urology, University Hospitals Southampton, NHS Trust, Southampton SO16 6YD, UK.