What is the most effective strategy to prevent catheter-associated urinary tract infections (CAUTIs) in hospitalized patients?

• A. Remove indwelling catheter as soon as it is no longer indicated
• B. Use prophylactic antibiotics
• C. Change catheter every 48 hours
• D. Use antiseptic-coated catheters

Answer: (A)

The most effective way to prevent catheter-associated urinary tract infections is to minimize catheter use by removing the indwelling catheter as soon as it is no longer indicated. The risk of CAUTI rises with every day a catheter remains in place, so reducing the duration of catheterization cuts the opportunity for bacteria to enter and form biofilms on the catheter surface. This approach directly targets the strongest predictor of infection.

Prophylactic antibiotics are not recommended for CAUTI prevention because they don’t reliably prevent infections and can promote antibiotic resistance and adverse effects. Changing the catheter every 48 hours does not lower infection risk and can increase disruption and contamination. Antiseptic-coated catheters may offer only modest benefits in some settings and are not a substitute for removing the catheter when it’s no longer needed. The best practice is daily reassessment of catheter necessity and removal as soon as indicated, with alternatives (like intermittent voiding plans or bladder scanning) used when appropriate.