Decreased incidence of bacteriuria associated with periodic instillations of hydrogen peroxide into the urethral catheter drainage bag

We determined the incidence and source of bacterial colonization of the bladder in 31 consecutive patients with acute spinal cord injury who required indwelling urethral catheterization. Patients were randomized to conventional drainage or to conventional drainage with a secondary sterile bag for periodic administration of saline or 3% hydrogen peroxide. The hydrogen peroxide group maintained sterile bladder urine significantly longer than the conventional drainage group (p less than 0.05). Cultures suggested that the reservoir for bladder colonization was the bag in 5 of 12 patients (42%) on conventional drainage. Instillation of hydrogen peroxide prevented bacterial contamination of the drainage bag before bladder bacteriuria (p less than 0.01) and also reduced drainage bag bacteriuria in patients with urinary infections (p less than 0.0005). The data indicate that bacterial contamination of the drainage bag is a frequent source of bladder bacteriuria that can be eliminated effectively by periodic instillation of hydrogen peroxide.