Preventing Infections in the Hospital

Watch out for these two practices

If you or someone you care for is in the hospital, there are two common medical practices that you should watch out for. Here’s why:

Both urinary catheters and ulcer drugs are overused in hospitals. And both increase the risk of infection.

The risks of urinary catheters.

Catheters are tubes to drain urine. They are usually used after surgery, or to keep track of how much urine you make.

But catheters aren’t always necessary. They are often used for the convenience of staff. And they are often left in too long.

The longer a catheter is in place, the more bacteria can grow. This can cause a urinary tract infection, or UTI. Catheter-related UTIs are the most common infection that people get in hospitals in the U.S.—there are over 500,000 cases a year. UTIs can lead to longer hospital stays and prescriptions for antibiotics. Sometimes the infections go to the bloodstream and cause death. They kill about 13,000 Americans each year.

The risks of ulcer drugs.

Many hospital patients are given drugs to help prevent ulcers and gastrointestinal bleeding. If someone has had these problems, the drugs may be helpful. They can also help people in intensive care, especially if they are on ventilators.

The two types of drugs are:

  • Proton-pump inhibitors such as propranazole (Prilosec and generic) and esomeprazole (Nexium and generic).
  • Histamine H2 receptor antagonists such as rantidine (Zantac and generic) and famotidine (Pepcid and generic).

However, too many patients are given these drugs: Some studies suggest that it’s between 50 and 75 percent of hospitalized patients. And many are wrongly sent home with prescriptions for the drugs. They may keep taking them for weeks or months.

The drugs kill off healthy bacteria in the gut. People taking these drugs are twice as likely to get a harmful infection called C. diff (short for Clostridium difficile). It causes severe diarrhea and is hard to treat with antibiotics. People taking the drugs are also more likely to get pneumonia.

Risky practices can cost a lot.

  • They add to hospital costs.
  • About 40 percent of people who wrongly take ulcer drugs in the hospital go home with prescriptions—which cost hundreds of dollars per year.
  • Each year, catheter-related UTIs add hundreds of millions of dollars to the national healthcare bill.

Ask about safer options.

Each day that you or someone you care about is in the hospital, ask the nurses and physicians if a catheter in place is still needed. The risk of infection rises greatly if a catheter is in for more than two days. There are other ways to measure urine. And adult pads can be used for bladder control problems. For males, a “condom catheter,” fitted outside the penis, is a good option.

If you, or someone you love or care for, is taking acid-suppressing medicine, ask if the patient has a high risk for a stress ulcer.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2017 Consumer Reports. Developed in cooperation with the Society of Hospital Medicine.

01/2014