Reusable Intermittent Catheters Reduce Antibiotic Use Without Increasing Urinary Tract Infections

Intermittent self-catheterization, used to empty the bladder several times a day, can leave patients vulnerable to recurrent urinary tract infections and repeated antibiotic use. Reliance on single-use catheters also adds to healthcare costs and plastic waste, but concerns that reusable devices could raise infection risk have limited patient choice. A new study shows that reusable intermittent urinary catheters are a safe alternative that may reduce antibiotic use while easing financial and environmental burdens.

Researchers at the University of Southampton evaluated reusable intermittent urinary catheters against standard single-use products. The investigation assessed safety and antibiotic exposure in routine self-catheter users over one year. Participants were assigned either to continue single-use-only practice or to adopt a mixed approach that included reusable devices.

Those in the mixed-use group received a cleaning kit and standardized protocol. Reusable catheters were washed with soap and water and then soaked in a chlorine solution before reuse. This process aimed to maintain safety comparable to opening a new sterile catheter each time.

The MultICath non-inferiority randomized controlled trial enrolled 578 participants and followed them for 12 months. Outcomes included symptomatic urinary tract infection incidence and antibiotic consumption. Findings were published in the International Journal of Nursing Studies.

Across the study period, 29% of the mixed-use group had at least one urinary tract infection, compared with about 34% in the single-use-only group. Patients using reusable catheters required 35% fewer antibiotics than those limited to single-use products, indicating no increase in infection risk and a potential reduction in antimicrobial exposure. The authors concluded that reusable options are a safe choice for intermittent catheter users.

The analysis highlighted system-level implications relevant to procurement and sustainability. The National Health Service (NHS) prescribes around 100 million single-use catheters annually, with expenditure rising from £22 million in 1998 to about £200 million in 2026. Trial pricing indicated reusable catheters cost less than 10p per use and can be reused for a month, while a box of 30 single-use catheters costs about £50, suggesting that even a 25% switch could save millions and reduce plastic waste.

“This study is a powerful example of how NIHR-funded research could lead to real-world impact, improving patient choice, saving the NHS millions, and reducing plastic waste. These findings will give the NHS the evidence it needs to consider introducing reusable catheters. It shows that thousands of people who use catheters every day could choose reusable catheters without concern about an increased risk of infection compared with single-use options, giving patients access to a more environmentally friendly choice,” said Professor Marian Knight, NIHR Programme Director of Programme Grants for Applied Research.

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