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Antibiotic prophylaxis prior to urodynamic study in patients with traumatic spinal cord injury. Is there an indication?
Silva, Marcello Torres da; Barboza, André Luis; Pijoán, Maria Malen; Beraldo, Paulo Sergio Siebra.
  • Silva, Marcello Torres da; Hospitais de Reabilitação. Serviço de Urologia. São Luís. BR
  • Barboza, André Luis; Hospitais de Reabilitação. Serviço de Urologia. Brasília. BR
  • Pijoán, Maria Malen; Instituto Universitario Italiano de Rosario. Rosario. AR
  • Beraldo, Paulo Sergio Siebra; Hospitais de Reabilitação. Serviço de Lesão Medular. Brasília. BR
Int. braz. j. urol ; 45(2): 347-353, Mar.-Apr. 2019. tab
Article in English | LILACS | ID: biblio-1002202
ABSTRACT
ABSTRACT Study

design:

Retrospective cohort of patients with traumatic spinal cord injury (SCI) that have been hospitalized for physical-functional rehabilitation purposes.

Objectives:

To compare the incidence of urinary tract infection (UTI) after urodynamic study (UDS) in three hospitals that adopted different protocols with regard to the preparation of patients.

Setting:

Sarah Network of Rehabilitation Hospitals, Brazil. Materials and

Methods:

Between 2014 and 2015, 661 patients from three units of the same hospital network, one of which does not use antimicrobial prophylaxis independently of urine culture results, were evaluated after having undergone UDS. The results were compared in both univariate and multivariate analyses (logistic regression).

Results:

The global rate of UTI after UDS was that of 3.18% (IC 95% 2.1-4.8), with no differences between the units. In the univariate analysis the only variable that was associated with UTI after UDS was that of T6 injuries or above (P = 0.029). The logistic regression has confirmed this result, with an adjusted odds ratio of 3.06 (IC 95% 1.01 to 9.26; P = 0.0476). The use of antimicrobial prophylaxis did not alter that risk.

Conclusions:

This study has demonstrated that the use of antimicrobials does not prevent UTI after UDS. Patients with T6 traumatic SCI or above have got three times more chance of developing UTI after UDS if compared to those with a T7 injury or below, independently of the use of antimicrobials. Even in these patients the use of antimicrobials would not be justified.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Spinal Cord Injuries / Urinary Tract Infections / Antibiotic Prophylaxis Limits: Adult / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2019 Type: Article Affiliation country: Argentina / Brazil Institution/Affiliation country: Hospitais de Reabilitação/BR / Instituto Universitario Italiano de Rosario/AR

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Full text: Available Index: LILACS (Americas) Main subject: Spinal Cord Injuries / Urinary Tract Infections / Antibiotic Prophylaxis Limits: Adult / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2019 Type: Article Affiliation country: Argentina / Brazil Institution/Affiliation country: Hospitais de Reabilitação/BR / Instituto Universitario Italiano de Rosario/AR