Review ArticlesThe efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis
Section snippets
Literature review
The literature review began with a computerized search of the MEDLINE database (January 1, 1966, to January 31, 1997) using the exploded keywords “silver” and “catheter.” The search was not restricted to citations in the English-language literature. References in retrieved articles were also scanned, and original authors, catheter manufacturers, and experts were contacted to identify other published or unpublished reports.
We included trials that used a silver-coated urinary catheter in the
Results
The initial literature search identified 117 reports. Of these, 10 were clinical trials comparing silver-coated urinary catheters with noncoated urinary catheters. One trial was excluded because an open urinary collection system was used (25). Another was excluded because most of the patients were bacteriuric at baseline (26). Thus, eight trials 27, 28, 29, 30, 31, 32, 33, 34 with a total of 2,355 patients satisfied inclusion criteria for the meta-analysis (Table 1, Table 2).
The summary OR for
Discussion
Our meta-analysis helps to clarify discrepant results among trials of silver-coated urinary catheters and provides information on the type of catheter most useful in preventing nosocomial urinary tract infections. Much of the heterogeneity between studies appeared to be due to differences in catheter type and study design. Silver alloy catheters were effective in preventing bacteriuria whereas silver oxide catheters were not, possibly because silver alloy remains in the catheter for a longer
Acknowledgements
We thank Walter E. Stamm, MD, for his critical review of an earlier draft of the manuscript and Yuya Hirata for translating the Japanese studies into English. This work was completed while Dr. Saint was a Robert Wood Johnson Clinical Scholar.
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