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Antibiotics for urethral catheterization in children undergoing cystography: retrospective evaluation of a single-center cohort of pediatric non-toilet-trained patients

  • Pierluigi Marzuillo
  • Stefano Guarino
  • Tiziana Esposito
  • Giuseppina Campana
  • Michela Stanco
  • Pier Francesco Rambaldi
  • Emanuele Miraglia del Giudice
  • Angela La Manna
Short Communication

Abstract

Antibiotics are often used to prevent post-catheterization urinary tract infections (UTIs) in patients undergoing cystography. However, there is no universally accepted protocol and the literature data are conflicting. We aimed to determine prevalence and risk factors of post-cystography UTIs in non-toilet-trained children. We retrospectively evaluated 216 non-toilet-trained children not assuming antibiotics when undergoing cystography. Only the patients with dilated vesico-ureteral reflux (VUR) assumed antibiotics just after the exam (within 15 min). One hundred eleven patients without vesico-ureteral reflux (VUR) and 29 patients with non-dilated VUR did not receive post-procedure antibiotics and did not develop UTIs. Out of the 76 patients who showed a dilated VUR and received post-procedure antibiotics, only 5 (6.6%) developed a UTI. The most significant factor associated with post-cystography UTIs was the presence of dilated VUR (p = 0.005) with the presence of bilateral VUR also being significant (p = 0.02).

Conclusion: Patients without dilated VUR or bilateral VUR could not benefit from antibiotic prophylaxis for cystography.

What is Known:

• There is no universally accepted protocol about antibiotic administration in children undergoing cystography.

• Literature data are conflicting.

What is New:

Among 216 non-toilet-trained children undergoing cystography, 111 patients without vesico-ureteral reflux (VUR) and 29 patients with non-dilated VUR did not receive post-procedure antibiotics and did not develop UTIs. Out of the 76 patients who showed a dilated VUR and received post-procedure antibiotics, only 5 (6.6%) developed a UTI.

• The most significant factor associated to post-cystography UTIs was the presence of dilated VUR (p = 0.005) with presence of bilateral VUR also being significant (p = 0.02).

Keywords

Urinary catheterization Cystography Urinary tract infections Vesico-ureteral reflux Children 

Notes

Acknowledgements

The authors thank Anna Di Iulio and Simona Malvone for English language editing of this manuscript.

Authors’ contributions

Study concept and design: Marzuillo, La Manna, Miraglia del Giudice.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Marzuillo, Guarino, Stanco.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Marzuillo, Guarino, Campana.

Study supervision: Rambaldi, La Manna, Esposito, Miraglia del Giudice.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Pierluigi Marzuillo
    • 1
  • Stefano Guarino
    • 1
  • Tiziana Esposito
    • 1
  • Giuseppina Campana
    • 1
  • Michela Stanco
    • 1
  • Pier Francesco Rambaldi
    • 2
  • Emanuele Miraglia del Giudice
    • 1
  • Angela La Manna
    • 1
  1. 1.Department of Woman, Child and of General and Specialized SurgeryUniversità degli Studi della Campania “Luigi Vanvitelli”NaplesItaly
  2. 2.Department of Radiological Sciences, Nuclear MedicineUniversità degli Studi della Campania “Luigi Vanvitelli”NaplesItaly

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