A Randomized Controlled Trial to Evaluate the Effectiveness of Gentamicin Bladder Instillation on CAUTI
St. Joseph's Hospital and Medical Center, Phoenix
Summary
Urinary tract infections in catheterized patients is an unacceptable complication and has been termed a 'never event' by the Center for Medicare \& Medicaid Services (CMS); however there is not consensus among clinicians on how to best prevent CAUTIs. We propose a prospective randomized controlled trial to test the efficacy of prophylactic gentamicin bladder irrigation in elimination of CAUTIs.
Description
Catheter Associated Urinary Tract Infection (CAUTI) is a hospital acquired infection considered preventable by the Center for Medicare \& Medicaid Services (CMS) and originally estimated to cost each individual patient approximately $4700 per infection in 2009 US dollars1. In the inpatient population, more contemporary calculations have associated the per patient cost to have risen to a mean of $13,793 per patient (range $4,694-$29,743)2, with an increased median length of stay of 3.6 days, and a 1.37 increased odds ratio of death3. CMS understandably has declared CAUTI a "never event", a ter…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. age greater than 18 2. admitted with a trauma, surgical, or neuro-critical care diagnosis 3. indwelling foley catheter in place Exclusion Criteria: 1. Documented positive UA or Urine Culture within the past 7 days or upon admission 2. Traumatic bladder injury 3. Gross hematuria 4. Chronic indwelling urethral or chronic suprapubic foley catheter 5. allergy to gentamicin or similar aminoglycosides
Interventions
- DrugGentamicin
random assignment to gentamicin or placebo bladder instillation to prevent CAUTI (catheterized urinary track infection)
Location
- St. Jpseph's Hospital and Medical CenterPhoenix, Arizona