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著者: Marc Leone, Anne-Sophie Perrin, Isabelle Granier, Pierre Visintini, Valery Blasco, François Antonini, Jacques Albanèse, Claude Martin
雑誌名: Intensive Care Med. 2007 Apr;33(4):726-9. doi: 10.1007/s00134-007-0534-1. Epub 2007 Feb 9.
Abstract/Text
OBJECTIVE: To determine the effect on the occurrence of urosepsis of a treatment with a short course of antibiotics and indwelling urethral catheter replacement in clinically asymptomatic intensive care unit (ICU) patients with a positive urine culture occurring at least 48 h after catheterization.
METHODS: A prospective randomized clinical trial was conducted in the medico-surgical ICU of a tertiary care centre. Sixty patients hospitalized in the ICU with an indwelling urethral catheter for longer than 48 h developing an asymptomatic positive urine culture were randomized to receive either a 3-day course of antibiotics associated with the replacement of the indwelling urethral catheter 4 h after first antibiotic administration or no antibiotics, no catheter replacement (standard of care).
RESULTS: Three patients in each group developed urosepsis (P=0.1). There were no significant differences in duration of mechanical ventilation between the study group and the standard of care group (9 [4-20] days vs 5 [2-15] days, P=0.2), in duration of urinary catheterization (22 [11-40] days vs 18 [14-33] days, P=0.8), or in length of ICU stay (28 [13-46] vs 19 [15-34], P=0.6). The recurrence of positive urine culture at days 7 and 15 was not affected by the randomization (P=0.1). The profile of bacterial resistance was similar in the two groups.
CONCLUSIONS: Treating a positive urine culture in an asymptomatic patient with an indwelling urethral catheter does not reduce the occurrence of urosepsis in the medico-surgical ICU.
PMID 17294169 Intensive Care Med. 2007 Apr;33(4):726-9. doi: 10.1007/s00134-007-0534-1. Epub 2007 Feb 9.
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