抗菌剤徐放性尿道留置カテーテルの効果 第1編: クロルヘキシジン徐放性天然ゴムFoley カテーテルの尿路感染防止効果について

Abstract

1)クロルヘキシジン徐放性Foleyカテーテル(SR-Cカテーテル)を使用すれば少なくとも3日以内の留置期間中は予防的抗菌剤療法は不要であった.2) SR-Cカテーテル使用による明らかな菌の耐性化は認めなかった.3)本カテーテルの使用は留置前から細菌尿に対する治療効果はなかった.4)測定した患者の大多数では尿中へは1～2 μg/mlクロルヘキシジンが長期間にわたり放出されていた.5)本カテーテル使用に伴う副作用として特記すべきものはなかった

Seventy five patients requiring urethral catheterization for over 24 hours were treated with a latex Foley catheter with sustained release of chlorhexidine in a closed drainage system. While the catheter was indwelling, urinary concentrations of chlorhexidine were maintained at the level of 1 to 2 micrograms/ml in average in almost all patients. The catheter was highly effective in preventing the acquisition of catheter-associated bacteriuria in patients with initially sterile urine without systemic antimicrobial therapy. The acquisition rate of bacteriuria was 8, 16, 23, 35 and 74% on day 3, 4, 5, 6 and 7 with the catheter indwelling, respectively. The catheter was not effective in eradicating preexisting bacteriuria. Complications of the catheter were minimal.