How do I prevent urinary tract infections in a quadriplegic with a suprapubic catheter?

Urinary antiseptic. Taking urinary antiseptic, e.g., methenamine mandelate (uroquid) along with maintaing strict sterile technique while catheterizing would reduce the incidents of uti.
Avoid blockages. If a suprapubic catheter is unavoidable, then: 1. Avoid blockage of the catheter at all times. 2. Avoid backwash of urine from the bag, into the catheter 3. Maintain the insertion site meticulously clean 4. Replace the catheter within a reasonable time, to avoid biofilm growth of bacteria up the catheter and into the bladder. 5. Only treat symptomatic uti's- not pyuria or asymptomatic bacteruria.
Remove catheter. You can not prevent utis in presence of an indwelling catheter, even if antibiotic coated.Subject needs to be on clean intermittent catheterization via urethra or via cutaneous appendico-vesicostomy.Alternative is a transurethral sphincterotomy to reduce bladder outflow resistance + wear an external condon catheter.Either way plans should be made to remove indwelling catheter unless terminally ill.

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