Intravesical Gentamicin Reduces Recurrent UTIs Safely: Study
In a recent clinical research study, it has shown promising efficacy and safety in the reduction of recurrent urinary tract infections and catheter-related problems when gentamicin is administered intravesically. Recurrent urinary tract infections and catheter problems are a significant cause of morbidity, especially in patients suffering from neurogenic bladder and chronic indwelling catheters. These problems often result in recurrent antibiotic use and the development of antibiotic resistance. This research study indicates that the use of gentamicin in a non-traditional manner is a promising approach in the reduction of recurrent urinary tract infections. The study was published in the journal of Neurourology and Urodynamics by Ned K. and colleagues.
This prospective, single-center study included adult patients with recurrent UTIs and/or catheter blockages receiving intravesical gentamicin from June 1, 2024, to April 1, 2025. A total of 55 patients were included, and 42 patients were found to be eligible, having received at least 14 days of therapy. The median patient age was 58 years, and 26 patients (62%) were female.
A significant number of patients had complex urological disorders, including 36 patients (86%) with neurogenic bladder and 38 patients (90%) using pre-existing catheters, including suprapubic, intermittent, and indwelling urethral catheters. The median follow-up time for these patients was 6 months. The intervention included once-daily intravesical instillation of gentamicin, 30-60 mL, 0.48 mg/mL, for 60 minutes.
Key findings:
Intravesical gentamicin resulted in a significant reduction in the number of subjective UTIs from a median of 6.5 to 0 and objective UTIs from 5.5 to 0 per 12-month-equivalent (p < 0.00001 for both).
Emergency visits were reduced from 1 to 0 per 12-month-equivalent (p = 0.005).
In catheter users, 47% had reduced blockages, although intervals for catheter change were unchanged at 28 days (p = 0.53).
Complications were mild (Grade I) in 26% of patients, while patient satisfaction was high (ease of use 4/5, would recommend 5/5).
The proportion of patients with multidrug-resistant UTIs was reduced from 70% to 23% (p = 0.00002).
This study shows that intravesical gentamicin is a safe and highly effective prophylactic intervention for decreasing recurrent UTIs and catheter-related issues, and that there is additional value in decreasing antimicrobial resistance and healthcare utilization.
Reference:
Kinnear, N., Coleman, L., Parsons, K., Casey, L., & Baverstock, R. (2026). Safety and Efficacy of Intravesical Gentamicin for Recurrent Urinary Tract Infections and/or Catheter Blockages. Neurourology and urodynamics, 10.1002/nau.70239. Advance online publication. https://doi.org/10.1002/nau.70239
