Catheter UTIs Cleared With Old-Fashioned Oxychlorosene Flush

Selected by Pietro Cazzola

UTIDenver – A 0.05% concentration of the antiseptic sodium oxychlorosene clears urinary tract infections as well as higher concentrations do in patients with urinary catheters, with significantly fewer side effects, a retrospective study showed.
Long used for surgical irrigation, oxychlorosene is a decades-old compound that’s regaining favor for UTIs amid concerns of antibiotic resistance. Typically, 100-150 mL are instilled through the catheter to clear residual urine, then another 100-150 mL, followed by a catheter clamp, to allow the solution to dwell in the bladder for about 10 minutes.
UTI studies dating back to the 1960s tended to use oxychlorosene in concentrations of up to 0.4%. However, after a median of six treatments over a period of 3 days, the investigators in the current study found that the 0.05% solution cleared infection in 58% (58/100) of study patients and curbed infection in 38% (38/100); a 0.2% comparator solution cleared infection in 50% (25/50) and tamed it in 40% (20/50).
The higher concentration caused bladder spasms in two patients and mild burning in two more. Just two patients reported burning sensations in the 0.05% group, and none reported spasms.
Most of the patients had bacterial infections, but some had yeast infections. Cultures in about a third of the 0.05% group grew multidrug-resistant organisms; multidrug-resistant organisms grew out of about half of the 0.2% cultures.
“You have just as good, if not slightly better, efficacy with the 0.05% concentration, and less adverse events. We’ve [switched to 0.05%,] and are still seeing really good clinical outcomes,” said lead investigator Andrea Stock, Pharm.D., an infectious disease specialist at Franciscan St. Francis Health in Indianapolis.
“Our in-vitro testing [showed] that oxychlorosene pretty much knocks out everything. We’ve tested it against yeast, multidrug-resistant pseudomonas,” Klebsiella pneumoniae carbapenemase–producing bacteria, extended-spectrum beta-lactamase–producing bacteria, and other organisms, she said.
The $2.50 cost per treatment, short duration of therapy, and “positive impact on further development of resistance” all lend support to its use for catheter-related UTIs, she said at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
Most in the study had a Foley catheter, but oxychlorosene also worked in patients with suprapubic catheters and those who self-catheterized.
About three-quarters of patients in both groups were on concomitant antibiotics. Patients were about 70 years old on average, and the majority of them were women.

Dr. Stock said she had no relevant financial conflicts.

MA Otto