A Multicenter Prospective Cohort Study of Antibiotics for OnabotulinumtoxinA.

Autor:	Morocco E; From the University of Southern California, Los Angeles, CA., Lua-Mailland L; Cleveland Clinic, Cleveland, OH., Werth A; Hartford Hospital, Hartford, CT., Carr D; Mount Auburn Hospital/Beth Israel Deaconess Medical Center, Boston, MA., Rabice S; University of Iowa, Iowa City, IA., Ashmore S; Northwestern University, Chicago, IL., Duong V; Massachusetts General Hospital, Boston, MA., Wilkes M; University of Rochester, Rochester, NY., Nilsson W; University of Connecticut, Farmington, CT., Ferzandi T; From the University of Southern California, Los Angeles, CA.
Jazyk:	angličtina
Zdroj:	Urogynecology (Philadelphia, Pa.) [Urogynecology (Phila)] 2024 Dec 13. Date of Electronic Publication: 2024 Dec 13.
DOI:	10.1097/SPV.0000000000001621
Abstrakt:	Importance: Urinary tract infection (UTI) is the most common complication of intradetrusor onabotulinumtoxinA (BTX-A) injection. Despite this, there are no evidence-based guidelines on antibiotic prophylaxis. Objectives: Our primary aim was to determine whether antibiotic prophylaxis decreased symptomatic, culture-proven UTI rates within 6 weeks of intradetrusor BTX-A injection. Our secondary aims were to determine if there are differences between antibiotic regimens and to identify risk factors for developing a UTI. Study Design: This was a prospective, observational multicenter cohort study of female patients receiving BTX-A for idiopathic overactive bladder. We compared patients who received antibiotics (nitrofurantoin or trimethoprim-sulfamethoxazole) to those who did not. To detect a 15% difference in UTI rates between groups (80% power, alpha = 0.05), 270 participants were needed. Results: A total of 282 participants ultimately received BTX-A and were included in the analysis. One hundred eighty-one (62.6%) were in the antibiotic cohort and 101 (35.8%) were in the no-antibiotic cohort. The overall rate of symptomatic, culture-proven UTI was 12.1%, and there was no difference between the antibiotic and no-antibiotic cohort (10.6% vs 14.9%, respectively; P = 0.29). On multivariable logistic regression, UTI was associated with older age (adjusted odds ratio [aOR], 1.07; 95% CI, 1.02-1.11), BTX-A dose of 200 units (aOR, 4.24; 95% CI, 1.45-12.35), and self-catheterization (aOR, 26.0; 95% CI, 3.62-186.5). The odds of symptomatic UTI were lower among postmenopausal participants (aOR, 0.13; 95% CI, 0.02-0.68) and participants in the Northeast United States (aOR, 0.23; 95% CI, 0.08-0.72). Conclusions: Our study did not find a lower rate of symptomatic, culture-proven UTI among participants who took antibiotics compared with those who did not. Competing Interests: The authors have declared they have no conflicts of interest. (Copyright © 2024 American Urogynecologic Society. All rights reserved.)
Databáze:	MEDLINE
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