Twice-Daily Nitrofurantoin Administration Following Short-term Transurethral Catheterization After Pelvic Reconstructive Surgery: A Randomized Clinical Trial
| Autor: | Dina Bastawros, Jing Zhao, Kelley Kaczmarski, Ryan Bender, E.M. Myers, Megan E. Tarr |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Reconstructive surgery Urology Anti-Infective Agents Urinary urologic and male genital diseases Placebo law.invention Postoperative Complications Randomized controlled trial Double-Blind Method law Interquartile range Internal medicine medicine Dysuria Humans Adverse effect Aged business.industry Urinary retention Obstetrics and Gynecology Middle Aged Plastic Surgery Procedures Urinary Retention female genital diseases and pregnancy complications Urinary Incontinence Nitrofurantoin Urinary Tract Infections Surgery Female medicine.symptom business Urinary Catheterization medicine.drug |
| Zdroj: | Female pelvic medicinereconstructive surgery. 27(3) |
| ISSN: | 2154-4212 |
| Popis: | Objective The objective of this study was to evaluate if twice-daily nitrofurantoin for 5 days after discontinuation of transurethral catheterization decreases the rate of urinary tract infection (UTI) in women with postoperative urinary retention (POUR) after pelvic reconstructive surgery. Methods This was a double-blind, placebo-controlled, randomized trial conducted across 2 clinical sites between October 2017 and April 2019. Women with acute POUR after pelvic reconstructive surgery were included and randomized to nitrofurantoin (100 mg) or placebo twice-daily for 5 days. The primary outcome was clinically suspected UTI (defined as dysuria, frequency, and irritation in the absence of vaginal discharge) and/or culture-proven UTI (defined as greater than 105 colony forming units of a single organism) within 30 days of surgery. Secondary outcomes included evaluation of adverse events related to study medication and medication adherence. Results Data from 164 participants were eligible for intention-to-treat analysis (nitrofurantoin, n = 82; placebo, n = 82). There were no significant demographic or intraoperative differences except for body mass index and race. Median duration of catheterization was 3 days (interquartile range, 2-5 days, P = 0.12). Fifteen women in the nitrofurantoin group and 14 women in the placebo group experienced UTI within 30 days (18.3% vs 17.1%; P = 0.84; odds ratio, 1.09; 95% confidence interval, 0.49-2.43). There were no study medication allergies; however, nausea was the most common intolerance. Most women in each group completed the study drug treatment (91.5% vs 86.4%, P = 0.30). Conclusions Nitrofurantoin prophylaxis after transurethral catheter removal did not reduce the risk of UTI in women with acute POUR after pelvic reconstructive surgery. |
| Databáze: | OpenAIRE |
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