Best practice policy statement on urodynamic antibiotic prophylaxis in the non‐index patient

Cameron, Anne P.; Campeau, Lysanne; Brucker, Benjamin M.; Clemens, J. Quentin; Bales, Gregory T.; Albo, Michael; Kennelly, Michael

doi:10.1002/nau.23253

Cited by 34 publications

(50 citation statements)

References 52 publications

(125 reference statements)

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“…• German Society of Urology (DGU) [18] • Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) [19] • Neurologic Incontinence Committee (NIC) [20] • European Association of Urology (EAU) [8] • National Clinical Guideline Centre (NCGC) [21]…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of the content and quality of clinical practice guidelines for management of the neurogenic bladder following spinal cord injury

et al. 2019

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Introduction Neurogenic bladder following acute spinal cord injury (SCI) increases urinary tract infection (UTI) risk and affects quality of life and health system costs. Objectives This study aimed to identify, describe and evaluate quality of clinical practice guidelines (CPGs) for managing neurogenic bladder following SCI. Methods A comprehensive search covered six electronic databases (PubMed, Web of Science, Health Systems Evidence, Cochrane, CINAHL, Epistomonikos) and 12 CPG portals. Inclusion criteria were English language CPG; includes recommendations for managing neurogenic bladder in adults; all phases of care; published 2011 onwards in peer-reviewed journal/CPG portal. For eligible CPGs, key characteristics including years covered by CPG searching and number of neurogenic bladder recommendations were extracted. Quality appraisal used the AGREE II instrument. Appraiser agreement was assessed using the intraclass correlation coefficient. Results Searching yielded 4028 citations and eight relevant CPGs. Collectively the CPGs contained 304 recommendations. Over half (160) pertained to assessment, surgery or education. Most surgery recommendations were from older CPGs; more recent CPGs emphasised conservative therapy. Methodological quality across CPGs was good in the domains of 'clarity of presentation' (84% mean domain score), 'scope and purpose' (72%) and 'editorial independence' (68%). There were shortcomings in the domains of 'rigor of development' (52%) 'stakeholder involvement' (42%) and 'applicability' (33%). Conclusion CPGs for the management of neurogenic bladder following SCI are generally robust in stating their scope and clearly presenting recommendations. Only three CPGs attained domain scores over 70% pertaining to methodological rigor. Future CPGs should also focus on providing implementation / audit resources and incorporating patient perspectives.

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Section: Resultsmentioning

confidence: 99%

“…Agree Item DGU 2017 [18] SUFU 2017 [19] NIC 2016 [20] EAU 2015 [5,6] NCGC 2012 [16] SIGN 2012 [22] JBI 2011 [4,18] CSCM 2006 [17] Mean Domain 1-Scope and purpose 1. The overall objective(s) of the guideline is (are) specifically described.…”

Section: Quality Appraisalmentioning

confidence: 99%

A systematic review of the content and quality of clinical practice guidelines for management of the neurogenic bladder following spinal cord injury

et al. 2019

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“…Their recommendations also suggest antibiotic prophylaxis for patients with any indwelling catheter or who perform clean intermittent self-catheterization. As a first choice of antimicrobial agents before UDS in high-risk patients, they recommended a single dose of trimethoprim‐sulfamethoxazole; however, the choice of prophylactic antibiotic should also include local pathogen resistance patterns [ 12 ]. We built upon these studies and recommendations in our recognition of high-risk patients in our study.…”

Section: Discussionmentioning

confidence: 99%

“…did not recommend routine antibiotic prophylaxis in patients with diabetes mellitus, they did define risk factors for the development of UTI after UDS. These are neurogenic lower urinary tract dysfunction, elevated postvoid residual urine (PVR), asymptomatic bacteriuria, immunosuppression, age >70, and patients with an indwelling catheter [ 12 ]. Indeed, the use of prophylactic antibiotics is still controversial due to their many adverse effects and because of the increase of resistance of bacterial uropathogens.…”

Section: Introductionmentioning

confidence: 99%

Should We Always Use Antibiotics after Urodynamic Studies in High-Risk Patients?

Miotła

Wawrysiuk

Naber

et al. 2018

BioMed Research International

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Aim The aim of this observational study was to evaluate the effectiveness of a phytotherapic drug (Canephron N) in preventing urinary tract infection (UTI) in high-risk women undergoing urodynamic studies (UDS). Methods The study protocol was approved by the local institutional ethical committee. Adult women with at least one risk factor for acquiring UTI (defined as: age over 70, elevated postvoid residual urine>100 ml, recurrent UTI, pelvic organ prolapse (POP) ≥II in POP-Q scale, and neurogenic bladder) had received after UDS either a single oral dose of fosfomycin trometamol (FT) (3 grams) or a phytodrug containing centaury herb, lovage root, and rosemary leaves (5 ml taken orally three times daily for one week). All patients included in the study had no pyuria according to urine dipstick (nitrite and/or blood and/or leukocyte esterase) and negative urine culture (CFU < 103/ml) before UDS. Urine samples were also tested 7 days after UDS. Results Seventy-two high-risk participants completed the study. Seven days after urodynamic studies UTI symptoms, pyuria (nitrite and/or blood and/or leukocyte esterase) and bacteriuria with E. coli occurred in two patients (one (2.8%) in the FT and one (2.7%) in the phytodrug group, respectively). No statistical differences in UTI incidence were found between both treatment groups. We did not observe any additional adverse events in both groups. The major disadvantage of prophylaxis with the phytodrug as compared to FT was the necessity of continuing therapy for 7 days. Conclusion Prophylaxis of UTI with a phytodrug (Canephron N) may be considered a good alternative to antibiotic prophylaxis use after UDS in high-risk female patients.

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“…In addition to official guidelines, other meaningful publications sponsored by the Society include a study investigating the accuracy of pad use for measuring post‐prostatectomy incontinence severity (conducted at 18 sites through the SUFU Pad Test Study Group and published in 2014) and a best practice policy statement on urodynamic antibiotic prophylaxis (published in 2017) . Lastly, the Society issued a position statement on mid‐urethral slings for stress incontinence (published in 2014 and updated in 2016) and provided a care map for patients with overactive bladder (https://sufuorg.com/resources/overactive-bladder-ccp.aspx).…”

Section: Society Publicationsmentioning

confidence: 99%

The history of the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction

Weissbart

Νitti

Lemack

et al. 2018

Neurourology and Urodynamics

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Best practice policy statement on urodynamic antibiotic prophylaxis in the non‐index patient

Abstract: These recommendations can assist urodynamic providers in the appropriate use of antibiotics for UDS testing. Clinical judgment of the provider must always be considered.

Cited by 34 publications

References 52 publications

A systematic review of the content and quality of clinical practice guidelines for management of the neurogenic bladder following spinal cord injury

A systematic review of the content and quality of clinical practice guidelines for management of the neurogenic bladder following spinal cord injury

Should We Always Use Antibiotics after Urodynamic Studies in High-Risk Patients?

The history of the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction

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