Antibiotics for People with Catheters

When they’re overused—and when they’re needed

Many older adults need help with bladder control. For some, that means having a catheter.

A catheter is a thin, flexible tube that is placed in the body to drain the bladder. It is usually used for a short time while you’re in the hospital. But some people, especially those in nursing homes, need a catheter longer.

Almost all people who have catheters have some bacteria in their urine. And many other people do too. But that doesn’t mean they all need antibiotics. Here’s what you need to know.

Usually, you don’t need antibiotics unless you have a urinary-tract infection (UTI).

Just because you have some bacteria in your urine, it doesn’t mean you have a UTI. If you don’t have an infection, taking antibiotics could be harmful.

Antibiotics have risks.

They can kill “friendly” germs and help drug-resistant bacteria to grow. This can lead to “antibiotic resistance.” This means that antibiotics may not work when needed in the future. Resistant bacteria cause illnesses that are harder to cure and more costly to treat. To treat them, a doctor may have to try a few different antibiotics. This increases the risk of side effects.

Using antibiotics can lead to vaginal yeast infections and other, more serious, infections.

Also, older adults often take other medicines that can interact dangerously with antibiotics.

Doctors should check for symptoms before ordering a urine test.

Some doctors—especially in nursing homes—routinely order urine tests for people with catheters. But that’s not necessary if you don’t have signs and symptoms of a UTI, such as:

  • Fever
  • A burning feeling when you urinate
  • A more urgent or frequent need to urinate (often in small amounts)
  • Blood in the urine
  • Confusion
  • Pain or tenderness in the pelvis, upper abdomen, or back

If you do have those symptoms, then a follow-up urine test can be a good idea. It tells the doctors if the diagnosis is correct. It also helps the doctor identify the type of bacteria that causes the infection.

When are antibiotics necessary?

Antibiotics make sense if:

  • You have symptoms of a UTI.
  • And your urine tests positive for a UTI.

You may also need antibiotics to treat other serious bacterial infections. And you may need antibiotics before some surgeries, such as prostate surgery and some procedures that involve the urinary system.

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

© 2016 Consumer Reports. Developed in cooperation with the American Urological Association.