Water or antiseptic for periurethral cleaning before urinary catheterization: A randomized controlled trial

Background: Despite a lack of empiric data to support the practice, traditionally, antiseptic solutions have been used to clean the periurethral area before inserting an indwelling catheter. The purpose of this study was to compare urinary colonization rates of subjects whose periurethral area was cleaned with water versus chlorhexidine 0.1% before the insertion of an indwelling urinary catheter. Methods: Obstetric patients who required urinary catheterization as part of their routine care were randomly assigned to either the “water” or “chlorhexidine” group with a sealed envelope. A sterile specimen of urine was collected 24 hours after insertion of the catheter. Results: Of the 436 patients (86.2%) with complete data (water group, 219; antiseptic group, 217), 38 (8.7%) had urinary tract bacteriuria >106 cfu/L. Rates of urinary tract infection were similar in each group (water group, 8.2%; antiseptic group, 9.2%; odds ratio 1.13; 95% confidence interval 0.58-2.21). Conclusion: The practice of periurethral cleaning with an antiseptic did not decrease the rates of bacteriuria in this population and is probably not useful. (Am J Infect Control 2001:29:389-94.)