Empirical Antibiotic Treatment Does Not Improve Outcomes in Catheter-Associated Urinary Tract Infection: Prospective Cohort Study

Tanya Babich, Oren Zusman, Michal Elbaz, Haim Ben-Zvi, Mical Paul, Leonard Leibovici, Tomer Avni

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Background Catheter associated urinary tract infection (CAUTI) is the most common healthcare-associated acquired infection. We aimed to describe the short- and long-term survival of patients with CAUTI and the impact of the empirical antibiotic treatment on survival rates. Methods In this prospective observational study we included consecutive adult patients with a chronic indwelling catheter-associated UTI and sepsis hospitalized in medical departments. The primary outcomes were 30-days all-cause mortality and long-term survival at end of the follow-up. A multivariate analysis using logistic regression and Cox proportional hazard model was performed to identify independent risk factors for an adverse outcome. A propensity-score model for receiving appropriate empirical antibiotic therapy was constructed and used to match patients. Results Overall, 315 consecutive patients with CAUTI were enrolled. The cohort consisted of elderly to very old patients (mean age 79.2 ± 11.5). The crude 30-day all-cause mortality rate was 30.8% (97/315). The median survival time was 82 days (interquartile range [IQR] 22-638). Appropriate early empirical treatment had no statistically significant association with 30-day mortality, propensity score-matched odds ratio (OR) 1.39 (0.76-2.55). Similarly, in the propensity-matched cohort, appropriate empirical treatment was not statistically associated with long-term survival (hazard ratio [HR] = 0.99, 95% confidence interval [CI] 0.75-1.3). Conclusions In our setting, patients with CAUTI had poor short- and long-term prognosis regardless of appropriate empirical antibiotic treatment. Avoiding empirical antibiotics for CAUTI might be an important antibiotic stewardship intervention in hospitals.

Original languageEnglish
Pages (from-to)1799-1805
Number of pages7
JournalClinical Infectious Diseases
Issue number11
StatePublished - 1 Dec 2017
Externally publishedYes

Bibliographical note

Funding Information:
Financial support. This work was supported by the Rabin Medical Centre Research Authority—The “young physician” funding and in part by the Israeli Ministry of Science, Technology and Space [grant 3-12075].

Publisher Copyright:
© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.


  • appropriate empirical treatment
  • catheter-associated urinary tract infection
  • long-term survival
  • mortality


Dive into the research topics of 'Empirical Antibiotic Treatment Does Not Improve Outcomes in Catheter-Associated Urinary Tract Infection: Prospective Cohort Study'. Together they form a unique fingerprint.

Cite this