Antibiotics and catheter management

Patients requiring antibiotic prophylaxis, with chronic obstruction and probable infection, require intravenous gentamicin or cefotaxime; an alternative is ciprofloxacin.

Asymptomatic catheterised patients are not treated until removal whereupon further treatment is organism dependent:

• gram positives - Strep. faecalis and coagulase negative staphylococci - are likely to resolve spontaneously
• gram negatives such as E. coli require oral antibiotics to clear infection. Prescribe according to sensitivity.

Blocked catheters that require replacement require chlorhexidine washout.

Patients with systemic symptoms such as pyrexia, and an indwelling catheter with contraindications to removal, should be checked for organism sensitivity; often the drug of choice is ciprofloxacin.