Antibiotic Use for Urodynamics: A Comprehensive Review that Informs Local Practice.

Area of Science:

• Urology
• Infectious Disease
• Evidence-Based Medicine

Background:

• The necessity of prophylactic antibiotics for all patients undergoing urodynamic testing remains unclear.
• Current literature lacks consensus on whether to universally administer antibiotics or target high-risk individuals.

Purpose of the Study:

• To determine the efficacy of routine antibiotic prophylaxis versus targeted prophylaxis for preventing urinary tract infections (UTIs) after urodynamic testing.
• To establish evidence-based guidelines for antibiotic use in this patient population.

Main Methods:

• A comprehensive literature search was conducted across major databases (MEDLINE, Embase, Ovid, Cochrane Library, CINAHL) from January 1995 to December 2014.
• Thirty publications were included in the analysis, focusing on antibiotic use, UTI prevention, and outcome measures.
• Urinalysis screening was identified as a widely accepted best practice.

Main Results:

• Many studies addressed antibiotic use, but definitions of outcomes (e.g., bacteriuria vs. UTI) and antibiotic coverage varied.
• Outcome measures ranged from 2 to 7 days, with some studies focusing on specific population subgroups.
• A low incidence of UTIs was observed in the general population post-urodynamic testing.

Conclusions:

• Urodynamic studies are associated with a low risk of UTIs, negating the need for routine antibiotic prophylaxis.
• Clinical practice should be guided by local audits of infection rates.
• Development of individually targeted antimicrobial prophylaxis guidelines, considering urinalysis, patient risk factors, and local susceptibility, is recommended.