A comparison of the efficacy of normal saline and Savlon solutions in periurethral cleaning to reduce catheter-associated bacteriuria: A randomized control trial

Int J Infect Dis. 2021 Apr:105:702-708. doi: 10.1016/j.ijid.2021.02.086. Epub 2021 Feb 23.

Abstract

Objective: Catheter-associated urinary tract infection (CAUTI) is a common nosocomial infection. However, there has been no randomized control trial (RCT) comparing the efficacy of periurethral cleaning solutions for reducing CAUTI. This study aimed to compare the efficacy of normal saline solution (NSS) and Savlon solution.

Methods: A non-inferiority cross-over RCT was conducted to compare the 2 solutions by the incidence of significant bacteriuria (SB) on day 5 after Foley catheterization. Patients admitted to a tertiary referral hospital from June 2018 to August 2019 participated in the study. The acceptable prespecified non-inferiority margin was 10%.

Results: There were 265 and 275 patients in the NSS and Savlon groups, respectively. The incidence of CAUTI was 2.65/1000 catheter-days, and the median duration of catheterization was 5 days (IQR 4, 7). There was no significant difference between the incidence of SB in the NSS and Savlon groups, as indicated by the adjusted difference of 0.6 (95% CI: -3.1-4.2).

Conclusion: This study was the first RCT in patients from multiple hospital units to compare the efficacy of the 2 solutions in the periurethral cleaning process. The study demonstrated non-inferiority of NSS to Savlon solution.

Thai clinical trials registry study id: TCTR20180518001.

Keywords: Catheter-associated urinary tract infection (CAUTI); Indwelling catheter; Normal saline solution; Periurethral cleaning; Savlon; Significant bacteriuria.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / therapeutic use*
  • Bacteriuria / epidemiology
  • Bacteriuria / prevention & control*
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control*
  • Catheters, Indwelling / adverse effects
  • Catheters, Indwelling / microbiology
  • Cetrimonium Compounds / therapeutic use*
  • Chlorhexidine / therapeutic use*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Drug Combinations
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Saline Solution / therapeutic use*
  • Treatment Outcome
  • Urinary Catheterization / adverse effects
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / prevention & control*
  • Young Adult

Substances

  • Anti-Infective Agents
  • Cetrimonium Compounds
  • Drug Combinations
  • Saline Solution
  • savlon
  • Chlorhexidine