A 5-day Antibiotic Course for Treatment of Intermittent Catheter-associated Urinary Tract Infection in Patients with Spinal Cord Injury

Overview

Journal Spinal Cord Ser Cases

Specialty Neurology

Date 2017 May 16

PMID 28503324

Citations 3

Authors

Jean-Gabriel Previnaire

Morgane Le Berre

Elisabeth Hode

Vincent Dacquet

Hemanou Bordji

Pierre Denys

Jean-Marc Soler

Affiliations

Soon will be listed here.

Abstract

Introduction: This was a retrospective monocentric study conducted at Centre Calvé, France, with the objective of evaluating the effectiveness of a 5-day course of antibiotics for symptomatic (mild urinary tract infection, UTI) or asymptomatic (aBact) bacteriuria in patients with spinal cord injury on intermittent catheterization.

Case Presentation: This study was conducted from May 2013 to September 2016. Antibiotic selection always followed culture collection and analysis of antibiograms. Patients with febrile UTI (>38°5) or recent history of urolithiasis were excluded.

Discussion: Fifty-seven patients underwent 111 5-day courses of antibiotics. The two main bacteria involved were and . Most commonly prescribed antibiotics were cephalosporins, cotrimoxazole, fluoroquinolones and nitrofurantoins. On day 4 of the antibiotic course, bacteria were eradicated in 99% of cases. Clinical cure occurred in all patients by day 5 (end of treatment). After treatment, recurrence of UTI occurred in 16% of patients at week 3, 38% at week 6 and 50% at week 9. This rate was not significantly different from patients initially treated for aBact (20%, 35% and 44%, respectively). The UTI-free period was significantly shorter after treatment for aBact (45.5 days) than after treatment for UTI (53.7 days). None of the following characteristics were found to be risk factors for UTI: level or severity of lesion, gender, voiding mode, use of anticholinergic drugs and time since lesion. Results of this study support the use of a short 5-day course of antibiotics to treat mild UTI in patients with spinal cord injury, and provide further evidence against treatment of aBact.

Citing Articles

Urinary Tract Infections in Relation to Bladder Emptying in Patients with Spinal Cord Injury.

Milicevic S, Sekulic A, Nikolic D, Tomasevic-Todorovic S, Lazarevic K, Pelemis S J Clin Med. 2024; 13(13).

PMID: 38999463 PMC: 11242679. DOI: 10.3390/jcm13133898.

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis.

M Amaral D, Pereira A, Rodrigues M, Gandarez M, Cunha M, Torres M Porto Biomed J. 2021; 4(6):e56.

PMID: 33501398 PMC: 7819542. DOI: 10.1097/j.pbj.0000000000000056.

Antibiotic prophylaxis prior to urodynamic study in patients with traumatic spinal cord injury. Is there an indication?.

da Silva M, Barboza A, Pijoan M, Beraldo P Int Braz J Urol. 2019; 45(2):347-353.

PMID: 30785698 PMC: 6541138. DOI: 10.1590/S1677-5538.IBJU.2018.0574.

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