Poly-L-lysine-coated catheters are safe and well-tolerated in adults requiring short-term catheterization

1. Poly-L-lysine (PLL)-coated catheters are well-tolerated, safe, and noninferior in preventing bacteriuria compared to noble metal alloys (NMA)-coated catheters in adults requiring short-term catheterization.

Evidence Rating Level: 1 (Excellent)

Catheter-associated urinary tract infections (CAUTI) account for approximately 40% of all nosocomial infections, leading to greater morbidity, extended hospital stays, and increased healthcare costs. Antibiotic- or silver-coated catheters have been shown to reduce rates of CAUTI, with NMA (consisting of gold, silver, and palladium) coated catheters being the most studied. This prospective, multi-centre, randomized controlled noninferiority trial sought to assess the efficacy and safety of a newly developed catheter coated with antimicrobial PLL in reducing the risk of bacteriuria compared to NMA-coated catheters. 300 patients who required indwelling catheterization for at least 24 hours were randomized to receive either PLL (n = 150; mean [SD] age, 57.6 [13.2] years; 34.67% female) or NMA (n = 150; mean [SD] age, 58.0 [12.6] years; 32.67% female) catheters. The mean duration of catheterization was 5.2 ± 1.8 days in the PLL group and 5.8 ± 2.7 days in the NMA group. There were 10 cases (6.9%) and 15 cases (10.1%) of catheter-associated bacteriuria in the PLL and NMA groups, respectively, with a difference of − 3.1% (95% CI [− 7.2%, 6.6%], p = 0.3195). 117 patients (78.0%) and 123 patients (82%) in the PLL and NMA groups, respectively, received antibiotics (p = 0.3862). There was a significantly lower proportion of patients in the PLL group experiencing abnormal urine white blood cells (6.2% vs. 12.8%, p = 0.0194). There was no difference in the incidence of adverse events (2.0% vs. 4.0%, p = 0.5011). PLL catheters are well-tolerated, safe, and noninferior in preventing bacteriuria compared with NMA catheters. Further studies with larger sample sizes are needed to confirm these results.

Click here to read the study in BMC Medicine

Image: PD

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