Clinical Effectiveness of Tap Water Versus Povidone-Iodine Bladder Irrigation for Recurrent Catheter-Associated Urinary Tract Infections: A Comparative Review of Contemporary Clinical Evidence.

Catheter-associated urinary tract infections (CAUTIs) remain among the most frequent healthcare-associated infections. Increasing antimicrobial resistance has renewed interest in bladder irrigation as a non-antibiotic therapeutic strategy. Tap water and povidone-iodine are two readily available irrigation solutions that have recently been evaluated in prospective clinical studies. A comparative narrative review was undertaken using two prospective clinical investigations published in peer-reviewed journals to compare the clinical effectiveness, safety, tolerability, and potential role of tap-water and povidone-iodine bladder irrigation in patients with recurrent CAUTIs. Study characteristics, patient demographics, intervention protocols, outcome measures, microbiological findings, safety outcomes, quality-of-life measures, and clinical applicability were compared qualitatively. Both bladder irrigation strategies appear clinically beneficial. Povidone-iodine demonstrated greater reductions in infection-related outcomes but involved daily antiseptic instillation in a narrowly defined neurogenic bladder population. Tap-water irrigation produced moderate reductions in antibiotic use and recurrent urinary tract infections while maintaining excellent patient acceptability and quality of life, suggesting an attractive low-cost strategy suitable for wider implementation. Direct comparative randomized trials are required.