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Thread: UTI catheter change

  1. #1

    UTI catheter change

    Hi!

    Is it better to change SP catheter before or after I start antibiotics ? I?ve been on day 3 of 14 days of Macrobid. My bag tubing and catheter smell like strong urine.
    Thanks

  2. #2
    We recommend changing an indwelling catheter prior to obtaining the urine for your culture and sensitivity test, which you should have for any UTIs prior to starting antibiotics.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    I always change my catheter 2 days after starting antibiotics. This gives the antibiotics a chance to kick in, before inserting a clean catheter. It works well for me.

  4. #4
    It is recommended to insert a new catheter before collecting the urine specimen for your C&S, which should be done before starting antibiotics. This way you get a good specimen that does not just culture the catheter, but what is actually in your urine/bladder/kidney.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  5. #5
    KLD, would you still recommend to change the catheter 2 days after starting antibiotics? I've been told by my doctor this is best practice to have a clean catheter to ensure the antibiotics are given the best chance to clear up the UTI. What are your thoughts?

  6. #6
    No, that is not our practice as long as we changed the catheter when obtaining the C&S. If you have a true UTI, that would also be the day that you would start antibiotics (after obtaining and submitting the specimen), with a change in medication if indicated when the final results of the C&S come back (72 hours).

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  7. #7
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    Quote Originally Posted by SCI-Nurse View Post
    No, that is not our practice as long as we changed the catheter when obtaining the C&S. If you have a true UTI, that would also be the day that you would start antibiotics (after obtaining and submitting the specimen), with a change in medication if indicated when the final results of the C&S come back (72 hours).

    (KLD)
    So change the catheter, submit the specimen and start antibiotics on the same day? How do they know what antibiotic to use until they get the results from the C&S?

  8. #8
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    Quote Originally Posted by HACKNSACK44 View Post
    So change the catheter, submit the specimen and start antibiotics on the same day? How do they know what antibiotic to use until they get the results from the C&S?
    Starting an antibiotic the same day after the specimen has been collected is probably easier done in the hospital setting than outside of that environment. Outside of the hospital, you have to find a physician who will prescribe a quantity of an antibiotic like Macrobid for you to have on hand in the likelihood that you will have a urinary tract infection and to trust you not to take the medication unless you have your typical symptoms and have collected a specimen and delivered it to a lab or office. That is not to say that it can't be done. I've been fortunate to have this kind of arrangement with all of my doctors who have monitored urinary tract infections. Also, some insurance companies may balk at covering medications to have on hand.

    Macrobid is a good short term antibiotic to get you through the time it takes to get a culture and sensitivity. It generally will knock down symptoms and keep you comfortable until your doctor selects an appropriate antibiotic a few days after a specimen has been submitted.

  9. #9
    Quote Originally Posted by HACKNSACK44 View Post
    So change the catheter, submit the specimen and start antibiotics on the same day? How do they know what antibiotic to use until they get the results from the C&S?
    Most physicians will prescribe a broad spectrum antibiotic based on a diagnosis of UTI made based on signs/symptoms (chills, fever, leaking around catheters, severe malaise, AD, etc.). Sometimes this is the right one, but the C&S results must be checked, and if not right, then it should be switched to a different antibiotic that shows sensitivity for this specific infection.

    Many people with SCI have an agreed upon arrangement with their PCP to get an order for the C&S and an initial antibiotic prescription called into your pharmacy when you report to them by phone that you have signs and symptoms of a true UTI. You should then call the PCP's office back 72 hours after submitting the specimen and ask them to check the C&S results and call in a new prescription for you if needed.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  10. #10
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    Why is it that a urinary tract infection always presents itself on Friday nights, Saturdays, Sundays, and over a long holidays like Labor Day, Memorial Day, or Thanksgiving when labs are closed? When our local hospital also ran a laboratory open to the public, I could take a specimen to the lab in the hospital 24/7. That was a major convenience that is no longer available. Thankfully, since the supra pubic was placed and I have continued use of Microcyn, I haven't had an infection in years! Hope I haven't just jinxed myself!

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