This protocol addresses lower urinary tract infection in patients who have an indwelling urinary catheter in place for more than 2 consecutive days, with microbiologically confirmed bacteriuria and at least one associated symptom or sign.
All of the following must be present:
Management begins with a catheter-related intervention, followed by antimicrobial therapy guided by urine culture results.
Clinical improvement with resolution of fever and urinary symptoms after initiation of antimicrobials.
DOI: 10.1053/j.ajkd.2023.08.009
Indwelling catheter in place for more than 2 consecutive days in an inpatient location.
Urine culture with no more than 2 organisms present and 1 organism with bacterium of >105 CFU/mL.
Presence of at least 1 of the following: fever (38 °C), suprapubic tenderness, costovertebral angle pain or tenderness, urinary urgency, urinary frequency, or dysuria.
The treatment for CAUTI includes first discontinuing the indwelling catheter or replacing the catheter (if still needed) if it has been in place for more than 2 weeks.
Antimicrobial therapy should be initiated in patients with suspected CAUTI and tailored to the urine culture results.
A duration of 7 days of antimicrobial therapy is likely sufficient, provided that the patient improves clinically after starting antimicrobials.
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