Instillation in Neurogenic Bladders to Decrease Unplanned Healthcare Encounters
Yale University
Summary
The goal of this clinical trial is to evaluate the feasibility and tolerability of 0.05% Chlorhexidine Gluconate (CGH) bladder instillations in an outpatient setting at the time of suprapubic catheter (SPC) exchange in patients with history of recurrent urinary tract infections (UTI). The main questions are: 1. is instillation of 150mL of CGH for five-minute duration at the time of SPC exchange feasible in an outpatient setting and tolerable for patients. 2. does this protocol decrease the rate of unplanned health care visits and improve patient quality of life. Patients will undergo the treatment protocol during their routine suprapubic catheter exchanges.
Description
Bacterial colonization is present in up to 95% of chronically catheterized patients. Although a positive urine culture collected from an indwelling catheter is not in isolation indicative of an acute urinary tract infection (UTI), long term catheter use is associated with increased rates of recurrent urinary tract infections (rUTI), pyelonephritis, and bacteremia. Using antibiotics for prevention of infections in this patient population can be challenging given the side effects, cost, and emergence of resistant bacteria with antibiotic therapy. To limit systemic side effects, intravesical irri…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Indwelling suprapubic catheter with insertion date at least 1 year prior to study enrollment date. * History of urinary tract infections, treated for at least 1 positive urine culture in last 6 months Exclusion Criteria: * Current radiographic evidence of urolithiasis * History of vesicoureteral reflux * History of renal transplantation * History of bladder augmentation * Inability to stop use of other rUTI prophylaxis treatments for the duration of their trial enrollment * Life expectancy of less than 12 months prior to consent. * Known hypersensitivity or allergy to…
Interventions
- DeviceBladder instillation with Irrisept
9 months of bladder instillations (3 months of saline and 6 months of chlorohexidine gluconate)
Location
- Yale New Haven HealthNew Haven, Connecticut