Comparison of different antibiotic protocols for asymptomatic bacteriuria in patients with neurogenic bladder treated with botulinum toxin A

Paradella, Ana Claudia; Musegante, André Ferraz de Arruda; Brites, Carlos

doi:10.1016/j.bjid.2016.08.012

Cited by 11 publications

(4 citation statements)

References 15 publications

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“…A cohort study of 46 patients with NB secondary to SCI found that treatment of asymptomatic bacteriuria failed to reduce the rate of infection when compared to treatment of complicated infections only ( 9 ). Two additional small observational studies assessed possible sequelae of not treating asymptomatic bacteriuria in patients with NB and found no increased incidence of upper tract damage or urosepsis ( 20 , 21 ).…”

Section: Resultsmentioning

confidence: 99%

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Tradewell

Pariser

Nimeh

et al. 2018

Transl. Androl. Urol.

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Urinary tract infection (UTI) is a source of morbidity and healthcare costs in adults with spina bifida (ASB). UTI prevention strategies are often recommended, but the evidence of various approaches remains unclear. We performed a systematic review to inform a best practice policy statement for UTI prevention in ASB. On behalf of the Neurogenic Bladder Research Group (NBRG.org), we developed an a priori protocol and searched the published English literature for 30 outcomes questions addressing UTI prevention in ASB. The questions spanned the categories of antibiotics, oral supplements, bladder management factors and social support. Where there was little literature in ASB, we included literature from similar populations with neurogenic bladder (NB). Data was abstracted and then reviewed with recommendations made by consensus of all authors. Level of Evidence (LoE) and Grade of Recommendation (GoR) were according to the Oxford grading system. Of 6,433 articles identified by our search, we included 99 publications. There was sufficient evidence to support use of the following: saline bladder irrigation (LoE 1, GoR B), gentamicin bladder instillation (LoE 3, GoR C), single-use intermittent catheterization (IC) (LoE 2, GoR B), hydrophilic catheters for IC (LoE 2, GoR C), intradetrusor onabotulinumtoxinA injection (LoE 3, GoR C), hyaluronic acid (HA) instillation (LoE 1, GoR B), and care coordination (LoE 3, GoR C). There was sufficient evidence to recommend against use of the following: sterile IC (LoE 1, GoR B), oral antibiotic prophylaxis (LoE 2, GoR B), treatment of asymptomatic bacteriuria (LoE 2, GoR B), cranberry (LoE 2, GoR B), methenamine salts (LoE 1, GoR B), and ascorbic acid (LoE1, GoR B). There was insufficient evidence to make a recommendation for other outcomes. Overall, there are few studies in UTI prevention in the specific population of ASB. Research in populations similar to ASB helps to guide recommendations for UTI prevention in the challenging patient group of ASB. Future studies in UTI prevention specific to ASB are needed and should focus on areas shown to be of benefit in similar populations.

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Section: Resultsmentioning

confidence: 99%

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Tradewell

Pariser

Nimeh

et al. 2018

Transl. Androl. Urol.

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“… 11 Paradellaa et al confirm that the use of a single dose of antibiotics before intravesical BTX injection in patients with asymptomatic bacteriuria is enough to prevent symptomatic UTI. 13 In comparison, Leitner et al investigated asymptomatic bacteriuria as a risk for UTI after BTX injections for NDO without antibiotic prophylaxis. In that study, post-injection UTI incidence was low (5–7%) and insignificant.…”

Section: Discussionmentioning

confidence: 99%

In Patients with Neurogenic Detrusor Overactivity and Hinman’s Syndrome: Would Intravesical Botox Injections Decrease the Incidence of Symptomatic Urinary Tract Infections

Banakhar¹,

Yamani²

2021

RRU

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Purpose To study the effect of intravesical Botox injection on the incidence of recurrent symptomatic UTI in neurogenic bladder patients with detrusor overactivity. Patients and Methods This was a prospective cohort study for patients who received Botox intravesical injection. We included patients with neurogenic bladder with detrusor overactivity and symptomatic recurrent UTI. We compared the number of symptomatic UTIs at six months pre- and post-intravesical Botox injection. Patient files were reviewed for diagnosis, vesico-uretric reflux, hydronephrosis, urodynamic findings pre- and post-injection, and dose of Botox used. Patients were followed for the number of symptomatic UTIs post-Botox injection. Results There were 93 patients diagnosed with neurogenic detrusor overactivity and symptomatic recurrent UTI. Patients were categorized into three categories: Group 1 – adults, Group 2 – pediatrics, Group 3 – non-neurogenic neurogenic bladder (Hinman’s syndrome). Spina bifida was diagnosed in 22 adults (Group 1) and 32 pediatric patients (Group 2). After receiving Botox injection, 75% of all patients (70) had a significant decrease in number of symptomatic UTIs. Urodynamic tests post-injection showed an improvement in bladder capacity, compliance, and detrusor pressure versus baseline in all three groups. Correlation analysis showed significant correlation between decreased symptomatic UTI post-Botox injection and detrusor pressure post-injection as well as bladder compliance; p -value=0.01 and p =0.021, respectively. Conclusion Intravesical Botox injection may decrease incidence of symptomatic UTI in neurogenic detrusor overactivity. This effect seemed to be related to better bladder management.

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“…It should be emphasized that the treatment of UTI should only be carried out when symptoms are present (113). Intravesical instillation of antibiotics after catheterization and the use of prophylactic low-dose oral antibiotic have been the subject of some studies; however, the results are conflicting (114)(115)(116). The use of oral ascorbic acid only seems to be helpful in association with antimicrobial agents (117).…”

Section: Intermittent Self-catheterization Complicationsmentioning

confidence: 99%

Neurogenic bladder – concepts and treatment recommendations

et al. 2022

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Introduction: Bladder and urinary sphincter malfunctioning that results from some change in the central and/or peripheral nervous system is defined as neurogenic bladder. The urinary tract symptoms that can be related to its filling, emptying, or both have a significant impact on the quality of life of individuals. The present review was based on the document prepared for the public health system in Brazil as a treatment guidelines proposal. Material and Methods: Survey questions were structured as per PICO (Population, Intervention, Control, and Outcome). Search strategies were defined and performed in the MEDLINE/Pubmed, Embase, Epistemonikos and Google Scholar databases. The selection of articles followed the evidence hierarchy concept; evidence body was identified, and the quantitative study data were extracted. The quality of evidence and grade of recommendation were qualitatively assessed according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Results: A total of 2.707 articles were identified, with 49 of them being selected to compose the basis for this review. Neurogenic bladder treatments were classified according to their focus on filling or emptying symptoms and sub-classified in pharmacological and surgical treatments. Conclusion: Treatment guidelines are important tools for the public health system to promote the best practice when treating neurogenic bladder patients.

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Comparison of different antibiotic protocols for asymptomatic bacteriuria in patients with neurogenic bladder treated with botulinum toxin A

Cited by 11 publications

References 15 publications

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

In Patients with Neurogenic Detrusor Overactivity and Hinman’s Syndrome: Would Intravesical Botox Injections Decrease the Incidence of Symptomatic Urinary Tract Infections

Neurogenic bladder – concepts and treatment recommendations

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