A comparison of antibiotic prophylaxis regimens to decrease the risk of post-procedure urinary tract infection after...

Area of Science:

• Urology
• Infectious Disease Prevention
• Pharmacology

Background:

• Onabotulinumtoxin A (BTX-A) injections are used for refractory idiopathic overactive bladder.
• Urinary tract infections (UTIs) are a potential complication following BTX-A treatment.
• Optimizing antibiotic prophylaxis timing may mitigate UTI risk.

Purpose of the Study:

• To evaluate the association between the timing of antibiotic prophylaxis initiation and the risk of post-injection UTI.
• To determine if starting antibiotics before BTX-A injection reduces UTI incidence compared to post-injection administration.

Main Methods:

• Retrospective cohort study of 111 women undergoing intradetrusor BTX-A injections.
• Two groups: pre-procedure antibiotic prophylaxis (ciprofloxacin 1 day prior) vs. post-injection only.
• Assessed UTI occurrence within 90 days post-injection; multivariable logistic regression used for analysis.

Main Results:

• Overall, 27% of patients developed a UTI within 90 days.
• The UTI rate was 22% in the pre-procedure antibiotic group versus 34% in the post-injection group.
• Adjusted analysis revealed a significant reduction in UTI risk (OR=0.23) for the pre-procedure antibiotic group.

Conclusions:

• Initiating antibiotic prophylaxis one day prior to BTX-A injection is associated with a lower risk of post-injection UTIs.
• Consideration of pre-procedure antibiotic prophylaxis for a total duration of 4 days may decrease UTI risk.
• Proactive antibiotic administration before BTX-A procedures warrants clinical consideration.