Urinary tract infection following intradetrusor onabotulinumtoxina injection for non-neurogenic urgency incontinence: single- vs. multi-dose prophylactic antibiotic treatment regimens.
antibiotic prophylaxis
botulinum toxin
urgency incontinence
urinary tract infection
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
01
02
2022
accepted:
13
05
2022
pubmed:
25
5
2022
medline:
25
2
2023
entrez:
24
5
2022
Statut:
ppublish
Résumé
Urinary tract infection is one of the most common adverse events following onabotulinumtoxinA injection for urgency incontinence. Our hypothesis was that those undergoing injection for urgency incontinence who received more than one dose of prophylactic antibiotics have lower post-procedure urinary tract infection rates compared to those who receive a single dose. We conducted a multi-center retrospective cohort study in females who underwent onabotulinumtoxinA injection for non-neurogenic urgency incontinence to evaluate the effect of single- vs. multi-dose prophylactic antibiotic regimens on the risk of post-procedure urinary tract infection. The primary outcome was the rate of urinary tract infection within 30 days of injection. Our sample size calculation required 136 subjects per group. Two hundred eighty-one patients were included from four centers. The single-dose cohort included 145 patients (51.6%), and the multi-dose cohort included 136 patients (48.4%). The mean age was 65 years, and patients were primarily Caucasian (81.4%). There was no difference in the rate of urinary tract infections diagnosed within 30 days of injection between the cohorts (single dose 13.8% vs. multi-dose 10.3%, p = 0.369). Those with a positive urine culture within 30 days of injection had a 15.2 times greater odds of having a post-procedure infection than those who did not (95% CI 3.19-72.53). There was no significant difference between the two cohorts in terms of adverse health events following injection. In females with non-neurogenic urgency incontinence undergoing onabotulinumtoxinA injection, multi-dose prophylactic antibiotic regimens were not associated with lower post-procedure urinary tract infection rates.
Identifiants
pubmed: 35608625
doi: 10.1007/s00192-022-05236-z
pii: 10.1007/s00192-022-05236-z
doi:
Substances chimiques
Botulinum Toxins, Type A
EC 3.4.24.69
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
729-736Informations de copyright
© 2022. The International Urogynecological Association.
Références
Gormley E, Lightner D, Burgio K. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline.; 2019. http://www.auanet.org/common/pdf/education/clinical-guidance/Overactive-Bladder.pdf .
Apostolidis A, Dasgupta P, Denys P. Recommendations on the use of botulinum toxin in the treatment of lower urinary tract disorders and pelvic floor dysfunctions: A European consensus report. Eur Urol. 2009;55(1):100–20. https://doi.org/10.1016/j.eururo.2008.09.009 .
doi: 10.1016/j.eururo.2008.09.009
Brubaker L, Richter HE, Visco A. Refractory idiopathic urge urinary incontinence and botulinum A injection. J Urol. 2008;180(1):217–22. https://doi.org/10.1016/j.juro.2008.03.028.Refractory .
doi: 10.1016/j.juro.2008.03.028.Refractory
Visco AG, Brubaker L, Richter HE. Anticholinergic therapy vs. onabotulinumtoxinA for urgency urinary incontinence. N Engl J Med. 2012;36(19):1803–13. https://doi.org/10.1097/01.ogx.0000427620.34769.ed .
doi: 10.1097/01.ogx.0000427620.34769.ed
Sievert KD, Chapple C, Herschorn S. OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder. Int J Clin Pract. 2014;68(10):1246–56. https://doi.org/10.1111/ijcp.12443 .
doi: 10.1111/ijcp.12443
Lightner DJ, Wymer K, Sanchez J, Kavoussi L. Best Practice Statement on Urologic Procedures and Antimicrobial Prophylaxis. Am Urol Assoc Educ Res. 2019;1-65. https://doi.org/10.1097/JU.0000000000000509 .
Lightner DJ, Wymer K, Sanchez J, Kavoussi L. Best Practice Statement on Urologic Procedures and Antimicrobial Prophylaxis. J Urol. 2020;203(6):351–6. https://doi.org/10.1097/JU.0000000000000789 .
doi: 10.1097/JU.0000000000000789
Allergan. Highlights of Prescribing Information. Allergan Pharmaceuticals. https://media.allergan.com/actavis/actavis/media/allergan-pdf-documents/product-prescribing/20190620-BOTOX-100-and-200-Units-v3-0USPI1145-v2-0MG1145.pdf . Published 2021.
Amundsen CL, Richter HE, Menefee SA, et al. Onabotulinumtoxin a vs sacral neuromodulation on refractory urgency urinary incontinence in women: A randomized clinical trial. JAMA - J Am Med Assoc. 2016;316(13):1366–74. https://doi.org/10.1001/jama.2016.14617 .
doi: 10.1001/jama.2016.14617
Houman J, Moradzadeh A, Patel D. What is the ideal antibiotic prophylaxis for intravesical botox injection? A comparison of two different regimens. Int Urogynecol J. 2019;30:701–4 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emex&NEWS=N&AN=616357445 .
doi: 10.1007/s00192-018-3721-4
Eckhardt SE, Takashima Y, Handler SJ, Tenggardjaja C, Yazdany T. Antibiotic regimen and route of administration do not alter rates of urinary tract infection after intravesical botulinum toxin injection for overactive bladder. Int Urogynecol J. 2021. https://doi.org/10.1007/s00192-021-04691-4 .
Bickhaus JA, Vaughan M, Truong T, Li YJ, Siddiqui NY. A comparison of antibiotic prophylaxis regimens to decrease the risk of post-procedure urinary tract infection after onabotulinum toxin A injection. Int Urogynecol J. 2020;31(9):1907–12. https://doi.org/10.1007/s00192-020-04230-7 .
doi: 10.1007/s00192-020-04230-7
FDA. FDA In Brief: FDA warns that fluoroquinolone antibiotics can cause aortic aneurysm in certain patients | FDA. https://www.fda.gov/news-events/fda-brief/fda-brief-fda-warns-fluoroquinolone-antibiotics-can-cause-aortic-aneurysm-certain-patients . Published 2018.
Hooton TM. Uncomplicated Urinary Tract Infection. N Engl J Med. 2012;366(11):1028–37. https://doi.org/10.1136/bmj.n725 .
doi: 10.1136/bmj.n725