American Urological Association
View all recommendations from this societyReleased June 11, 2015; sources updated May 9, 2016 and May 26, 2017
Don’t prescribe antimicrobials to patients using indwelling or intermittent catheterization of the bladder unless there are signs and symptoms of urinary tract infection.
Antibiotics in the absence of signs and symptoms (which may include fever; altered mental status or malaise with no other cause; flank or pelvic pain; flank or suprapubic tenderness; hematuria; dysuria, urinary urgency or frequency; and, in spinal cord injury patients, increased spasticity, autonomic dysreflexia or sense of unease) is not efficacious and risks inducing resistance to antimicrobials. This applies to both indwelling and intermittent catheterization of the bladder. The major exception is patients needing periprocedural antimicrobials. Additionally, initial placement of a suprapubic tube requires a skin puncture or incision and therefore antibiotics should be considered.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
How The List Was Created
1–5: The American Urological Association (AUA) established a committee to review evidence from the association’s guidelines and identify potential topics for nomination to the AUA’s Choosing Wisely list. The committee reviewed a number of recommendations and through a consensus process identified the five tests or procedures that should be questioned. These recommendations were reviewed and approved by the AUA Board of Directors.
6–10: Following its previous successful participation in Choosing Wisely in 2013, the American Urological Association (AUA) established a new committee in 2014 to develop a second list of recommendations. The group sought input from the AUA membership in addition to drafting potential suggestions after studying evidence from the association’s evidence-based clinical practice guidelines and other clinical documents. The committee reviewed all recommendations and narrowed them to a list of fifteen possibilities. Again, the committee sought AUA member input by asking members to vote for their top five selections from the list of candidate recommendations. After the votes were tallied, the list of five recommendations was determined. These recommendations were reviewed and approved by the AUA Board of Directors in February 2015.
11-15: To continue its successful participation in Choosing Wisely, the American Urological Association (AUA) established a new committee in 2016 to develop a third list of recommendations. The group sought input from the AUA membership in addition to drafting potential suggestions after studying evidence from the association’s evidence-based clinical practice guidelines and other clinical documents. The committee reviewed all recommendations and narrowed them to a list of twelve possibilities. Again, the committee sought AUA member input by asking members to vote for their top five selections from the list of candidate recommendations. After the votes were tallied, the list of five recommendations was determined. These recommendations were reviewed and approved by the AUA Board of Directors in March 2017.
AUA’s disclosure and conflict of interest policy can be found at www.auanet.org.
Sources
Diagnosis, prevention, and treatment of Catheter-Associated Urinary Tract Infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America [Internet]. Arlington (VA): Infectious Diseases Society of America; 2010 [cited 2014 Nov 4]. Available from: https://academic.oup.com/cid/article-lookup/doi/10.1086/650482.
