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Eur Urol. 2014 Oct;66(4):615-8. doi: 10.1016/j.eururo.2014.05.035. Epub 2014 Jun 21.

Cost effectiveness of antimicrobial catheters for adults requiring short-term catheterisation in hospital.

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Health Economics Research Unit, University of Aberdeen, Aberdeen, UK. Electronic address:
Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Academic Urology Unit, University of Aberdeen, Aberdeen, UK.


Catheter-associated urinary tract infection (CAUTI) is the second most common cause of hospital-acquired infection. A number of strategies have been put forward to prevent CAUTI, including the use of antimicrobial catheters. We aimed to assess whether the use of either a nitrofurazone-impregnated or a silver alloy-coated catheter was cost-effective compared with standard polytetrafluoroethylene (PTFE)-coated catheters. A decision-analytic model using data from a clinical trial conducted in the United Kingdom was used to calculate the incremental cost per quality-adjusted life-year (QALY). We assumed that differences in costs and QALYs were driven by difference in risk of acquiring a CAUTI. Routine use of nitrofurazone-impregnated catheters was, on average, £7 (€9) less costly than use of the standard catheter over 6 wk. There was a >70% chance that use of nitrofurazone catheters would be cost saving and an 84% chance that the incremental cost per QALY would be less than £30 000 (€36 851; a commonly used threshold for society's willingness to pay). Silver alloy-coated catheters were very unlikely to be cost-effective. The model's prediction, although associated with uncertainty, was that nitrofurazone-impregnated catheters may be cost-effective in the UK National Health System or a similar setting.


Antimicrobial catheters; Catheter-associated symptomatic urinary tract infection; Cost effectiveness; Costs; Decision-analytic model; Randomised controlled trial

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