Our economic analysis did not compare silver-coated catheters with antibiotic catheters. We assessed the clinical and economic consequences of using urinary catheters coated with silver alloy rather than standard, noncoated urethral catheters. Estimates of clinical effectiveness for the silver-coated urinary catheters were derived from 5 randomized trials performed by investigators other than us. We were, therefore, somewhat constrained by the data collected in the primary studies. Unfortunately, none of these trials reported the incidence of presumed argyria. Additionally, all of these trials1- 5 primarily used urinary catheters in patients requiring short-term catheterization (ie, approximately 2-10 days), thereby limiting the exposure to the silver catheter. However, the potential adverse effect of argyria in patients using silver-coated urinary catheters, especially for long-term use, remains a theoretical possibility, and, thus, this adverse effect may need to be monitored in future applicable clinical trials.
Saint S. Do Silver Alloy Catheters Increase the Risk of Systemic Argyria?—Reply. Arch Intern Med. 2001;161(7):1014-1015. doi: