Q. I’ve been managing my bladder with a Foley indwelling catheter. I’m always looking for extra ways or ideas to avoid UTIs, and I heard about a catheter that is coated with some type of antibiotic. Is there such a thing? And if so does it work?
A. Craig, your questions are timely. To answer to your first question, there is a new antibacterial (not antibiotic) infused catheter that recently entered the consumer market.
To help answer your second question we need to look at one of the main ways bacteria get into a bladder that is managed by an indwelling (Foley) catheter and how an antibacterial agent in a catheter can help reduce the chances of this happening.
As soon as an indwelling urinary catheter is put in place, a microscopic film — referred to as biofilm — rapidly starts to form on the catheter. A 2008 study done at Cardiff University in the UK showed significant biofilm growth on catheters after just 18 hours. This layer of biofilm creates a pathway for the bacteria — they march up the biofilm where they take hold in the bladder, multiply and cause a urinary tract infection.
In addition to creating a bacterial pathway to the bladder, the biofilm layer can also cause encrustation, a crystalline buildup that can block the catheter and can stop the flow of urine. An antibacterial indwelling catheter should help in reducing encrustation. However, the Cardiff study observed that simply putting antibacterial material on an indwelling catheter was not enough; to be effective the antibacterial material needs to diffuse into the urine to effectively fight UTI and encrustation.
A PubMed search revealed several recent papers and clinical trials on indwelling catheters infused with antibacterial agents. The studies found that nitrofurazone — a broad-spectrum antibacterial agent — was the most effective antibacterial coating for reducing UTIs. The studies concluded that the use of nitrofurazone-coated indwelling catheters resulted in a significant reduction in the incidence of UTIs.
In August 2009, Rochester Medical introduced a new line of all-silicone (important for people with latex allergies) nitrofurazone-impregnated Foley catheters. The Rochester design impregnates both the inner and outer surfaces of the catheter with nitrofurazone. The catheters are designed to elute a controlled release of nitrufurazone into the urethra and bladder — hence addressing the need to diffuse the antimicrobials into the urine to fight UTI and encrustation. A 2007 study showed that the Rochester Foley continued to elute nitrofurazone at or above bactericidal (high enough to kill bacteria) levels for at least 30 days.
The Foley version of Rochester’s nitrofurazone-impregnated catheter is called the StrataNF, and is the only Foley catheter indicated for the reduction of bacterial catheter-associated UTIs (CAUTI). The company also offers intermittent versions of the nitrofurazone-impregnated catheters called the Magic3 + antibacterial, and Magic3 + antibacterial plus hydrophilic.
The catheters are covered under Medicare. As always, it is a good idea to check with your insurance company in advance.
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