From the Guidelines
You should treat for a catheter infection if there is pus around a suprapubic catheter site, and the catheter should be removed and cultured if there is erythema or purulence overlying the catheter exit site, or clinical signs of sepsis 1. The presence of pus indicates a local infection that requires prompt treatment. Start with empiric antibiotic therapy such as amoxicillin-clavulanate 875/125 mg twice daily for 7-10 days, or trimethoprim-sulfamethoxazole DS twice daily for 7 days if penicillin allergic. Clean the site daily with sterile saline and apply an antimicrobial ointment like mupirocin. Change the dressing using sterile technique, keeping the area dry and clean. Collect a wound culture before starting antibiotics if possible to guide targeted therapy. These infections occur because the catheter creates a direct pathway for bacteria to enter the body, with common pathogens including Staphylococcus species, Escherichia coli, and Pseudomonas aeruginosa. Untreated catheter site infections can progress to more serious conditions like cellulitis, abscess formation, or systemic infection, so prompt treatment is essential.
Some key points to consider in the management of catheter-associated infections include:
- The type of catheter involved, with nontunneled central venous catheters (CVCs) and tunneled CVCs or implantable devices having different management strategies 1
- The severity of the patient's illness, with complicated infections requiring more aggressive treatment 1
- The specific pathogen involved, with some pathogens such as Staphylococcus aureus and Candida species requiring more prolonged treatment 1
- The use of antibiotic lock therapy, which may be effective in salvaging the catheter in some cases 1
Overall, the management of catheter-associated infections requires a comprehensive approach that takes into account the type of catheter, the severity of the infection, and the specific pathogen involved. Prompt treatment with empiric antibiotic therapy and removal of the catheter if necessary is essential to prevent complications and improve outcomes 1.
From the FDA Drug Label
When staphylococcal infections are localized and purulent, antibiotics are used as adjuncts to appropriate surgical measures The treatment for a catheter-associated infection with purulent discharge around the suprapubic site likely involves surgical measures along with antibiotic therapy.
- The choice of antibiotic should be based on culture and susceptibility results.
- Vancomycin may be effective against staphylococcal infections, but its use should be guided by susceptibility data 2.
- Gentamicin may also be effective against certain bacterial infections, but its use should be based on in vitro susceptibility tests 3.
- It is essential to remove the catheter and drain the infection site as part of the treatment.
From the Research
Treatment for Catheter-Associated Infection with Purulent Discharge
- The treatment for a catheter-associated infection with purulent discharge around the suprapubic site is not explicitly stated in the provided studies.
- However, the studies suggest that catheter-associated urinary tract infections (UTIs) can be managed with empirical antibiotic treatment, especially in cases of serious infection or in patients with a history of previous antibiotic therapy or healthcare-associated bacteraemia 4.
- The use of hydrophilic-coated catheters for clean intermittent catheterization can effectively reduce infections 4.
- Suprapubic catheters are not superior to urethral catheters in terms of reducing the rate of catheter-related bacteriuria, and the risk of catheter-associated UTI may not be minimized by suprapubic catheters 5.
- Patient education and proper care of the suprapubic catheter site are important to prevent infection 6, 7.
- The management of suprapubic catheters, including changing the catheter and drainage systems, is crucial to prevent infection 6.
- Antibiotic prophylaxis at the time of catheter placement may decrease the risk of microbial suprapubic catheter colonization 5.