Clean intermittent catheterisation (CIC) has been used as the effective method of bladder drainage in paraplegics for over a decade in our centre. In 27 acute spinal cord injury (SCI) patients managed by CIC from day one, symptomatic urinary infection occurred in 5 with a follow up period of 10 days to 3 months. No prophylactic/suppressive antibiotics were used. In 21 patients on long term CIC (1-12 years) symptomatic infections occurred during a 6 month follow up at a rate of 0.07 episodes per patient per month. Urine cultures proved positive in 26%. The types of bacteria and their sensitivity towards antibiotics were different in both groups.