**8. Other preventive measures**

The use of prophylaxis for CAUTI with cranberry products is mentioned in the IDSA guide‐ lines but not in the CDC, with the note that cranberry products should not be used routinely to reduce CAUTI in patients with neurogenic bladders with chronic intermittent OR indwel‐ ling catheters. They also noted insufficient date to recommend using cranberry products for other groups. However, these guidelines were published in 2009 before more recent studies that have shown some benefit to cranberry products. The previously cited study by Mutlu, although small, concluded that cranberry capsules could be an encouraging option for the prevention of recurrent UTI in children with neurogenic bladder caused by myelomeningocele who required chronic intermittent catheterization [47.] Because cranberry capsules are safe, inexpensive, well tolerated and don't cause any drug resistance, it would seem worthwhile to use them in these high risk populations as a first line preventive measures.

can decrease the infection rate. Most importantly, catheters should be placed only for accepted indications and not for incontinence or convenience. For postoperative female patients undergoing uncomplicated procedures, including gynecologic procedures, we should rethink the practice of routine foley placement during the procedure. Instead, consider intermittent in/out catheterization until she is able to ambulate and void satisfactorily. For men without cognitive impairment and obstruction, a condom catheter should be used. More research is needed in the bladder management of the postoperative patient, as well as the role of cranberry to prevent CAUTI. When Foleys are placed, the need for ongoing catheterization should be assessed daily and the catheter discontinued as soon as possible. Reminder systems, whether an electronic reminder or a paper sticker for those not yet using electronic systems, have been

Prevention of Urinary Tract Infections in the Outpatient and Inpatient Settings

http://dx.doi.org/10.5772/56709

19

shown to lower infection rates and should always be used when a foley is placed.

Wake Forest School of Medicine, Department of Obstetrics and Gynecology, Winston-Salem,

[1] Boscia JA, Abrutyn E, Kaye D. Asymptomatic bacteruria in elderly persons: Treat or

[2] World Health Organization, Department of Communicable Disease. Surveillance and

[4] Mabeck CE: Treatment of uncomplicated urinary tract infection in non-pregnant

[5] Foxman, B, Chi JW. Health behavior and urinary tract infection in college aged wom‐

[7] Dallosso H, McGrother C, Matthews R, Donaldson M, and the Leicestershire MRC Incontinence study group. The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int

[8] Arya LA, Myers DL, Jackson ND. Dietary caffeine intake and the risk for detrusor in‐

do not treat?, Ann Intern Med 1987: 106(5) 764-766

[6] Rinke C. Hot Tub Hygiene. JAMA 1983;250(15) 2031-2031.

stability: a case-control study. Obstet Gynecol 2000;96 85–9.

[3] Griebling TL. J Urol 2005; 173(4) 1281-7

women. Postgrad Med J 1972; 48 69-75.

en. J Clin Epidemiol.1990;43(4) 329-37.

**Author details**

Leslie Kammire

**References**

North Carolina, USA

Response 2002.

2003;92 69–77
