Volume 29, Issue 164, October 2025

Efficacy and Safety of Polyhexanide (PHMB)-Based Irrigation Solutions for Catheter Flushing in the Prevention of Catheter-Associated Urinary Tract Infections: A Literature Review

Kamil Nieczaj^1♦, Marta Tortyna², Marta Urszula Marciniak³, Danuta Borowska⁴, Julia Urbańska⁵, Paula Szarek⁶, Olga Samsel⁷, Natalia Sioch⁸, Julia Krotofil⁹, Maciej Trzciński¹⁰, Julia Sztubińska¹¹

¹Faculty of Medicine, Medical University of Gdańsk, Poland
²Faculty of Medicine, Medical University of Gdańsk, Poland
³Faculty of Medicine, Medical University of Gdańsk, Poland
⁴Faculty of Medicine, Medical University of Gdańsk, Poland
⁵Faculty of Medicine, Medical University of Gdańsk, Poland
⁶Faculty of Medicine and Health Sciences, Collegium Medicum of the University of Zielona Góra, Zielona Góra, Poland
⁷Faculty of Medicine, Medical University of Gdańsk, Poland
⁸Faculty of Medicine, Medical University of Gdańsk, Poland
⁹Faculty of Medicine, Medical University of Gdańsk, Poland
¹⁰Faculty of Medicine, Medical University of Gdańsk, Poland
¹¹Faculty of Medicine, Medical University of Gdańsk, Poland

^♦Corresponding author
Kamil Nieczaj, Faculty of Medicine, Medical University of Gdańsk, Marii Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland

ABSTRACT

Introduction: Catheter-associated urinary tract infections (CAUTIs) are common in patients with long-term catheterization, mainly due to biofilm formation on the catheter surface. Biofilms reduce the effectiveness of systemic antibiotics and standard flushing. Polyhexanide (PHMB) is a broad-spectrum antiseptic proposed as an irrigating solution to address these issues. Objectives: To review current literature on 0.02% PHMB irrigation in the prevention of CAUTI and maintenance of indwelling urinary catheters (IUC). Methods: A narrative review was performed using PubMed, Google Scholar, ScienceDirect, and supplementary sources for studies up to May 2025. Inclusion criteria were experimental and clinical studies assessing PHMB irrigation in catheterized patients or catheter models. Four studies met the criteria: two in vitro and two clinical. Results: In vitro: 0.02% PHMB significantly reduced biofilm and colony formation on catheter materials compared with saline or no treatment (p < 0.01). Clinical: In 74 chronically catheterized patients, PHMB irrigation was well tolerated, with no serious adverse events and only mild, transient local symptoms. Some patients reported fewer catheter blockages, odor, and discomfort. However, trials lacked randomization, had short follow-up periods, and reported limited microbiological outcomes, which restricted their generalizability. Conclusions: Irrigation with 0.02% PHMB appears to be a safe modality for reducing biofilm and maintaining the catheter. Preliminary clinical data demonstrate good patient acceptance; however, well-designed, randomized controlled trials with long-term follow-up are needed to confirm efficacy and determine the optimal regimen.

Keywords: Polyhexanide irrigation, Catheter-associated urinary tract infections, PHMB flushing, Antimicrobial catheter care, Biofilm reduction, CAUTI prevention

Medical Science, 2025, 29, e202ms3626

PDF

Published: 07 October 2025