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Are prophylactic antibiotics necessary with clean intermittent catheterization? A randomized controlled trial
Simon A Clarke1, Madan Samuel, Su-Anna Boddy
1Department of Paediatric Surgery, St Georges Hospital Medical School, Tooting, London, SE17 8QT, UK. sclarke3005@aol.com
Journal of Pediatric Surgery
|March 29, 2005
Summary
Discontinuing antibiotic prophylaxis for clean intermittent catheterization may reduce urinary tract infections (UTIs). This study found higher UTI rates in children who continued antibiotics, suggesting prophylaxis may not be necessary and could increase resistance.
Area of Science:
- Urology
- Infectious Diseases
- Pediatrics
Background:
- Clean intermittent catheterization (CIC) is a long-standing practice for managing bladder emptying.
- The necessity of antibiotic prophylaxis alongside CIC has been debated but not rigorously tested.
Purpose of the Study:
- To evaluate the efficacy of antibiotic prophylaxis in preventing urinary tract infections (UTIs) in pediatric patients undergoing CIC.
- To determine if discontinuing prophylactic antibiotics impacts UTI rates.
Main Methods:
- A randomized controlled trial was conducted with 85 patients.
- Participants were randomized into two groups: one continuing antibiotics and one discontinuing them.
- The study duration was 4 months, with confirmed UTI as the primary outcome measure.
Main Results:
- The group that discontinued antibiotic prophylaxis experienced significantly fewer UTIs (3 cases) compared to the group that continued antibiotics (20 cases).
- Escherichia coli was identified as the most frequent causative organism in UTIs.
Conclusions:
- Prophylactic antibiotic use in children undergoing CIC may be unnecessary.
- Discontinuing antibiotics could potentially lower UTI rates and mitigate the development of antibiotic-resistant organisms.