Abstract
The objective of this paper is to compare the risks and benefits of antibiotics to prevent urinary tract infection (UTI) after urodynamics. We developed a decision analytic model to compare the use of prophylactic antibiotics with no antibiotic use after urodynamics to prevent UTI. Risks and benefits were estimated from the literature and by consensus. The main outcome measure was the occurrence of UTI. Secondary outcomes were the development of adverse events and possible sequelae. One-way sensitivity analyses estimated the effect of varying each characteristic through its range while all other characteristics were fixed at their baseline values. The effectiveness of prophylaxis after urodynamics was a reduction of UTI from 9.2 (no antibiotics) to 5.3% (antibiotics). One-way sensitivity analysis of the probability of UTI without prophylaxis yielded a threshold infection rate of 10%, below which, the strategy of no prophylaxis was favored. In this model, prophylactic antibiotics after urodynamics are not beneficial until the rate of UTI without antibiotics exceeds 10%.
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References
Coptcoat MJ, Reed C, Cumming J, Shah PJR, Worth PHL (1988) Is antibiotic prophylaxis necessary for routine urodynamics investigations? Br J Urol 61:302–303
Bergman A, McCarthy TA (1983) Antibiotic prophylaxis after instrumentation for urodynamic testing. Br J Urol 55:568–569
Yip SK, Fung K, Pang MW, Leung P, Chan D, Sahota D (2004) A study of female urinary tract infection caused by urodynamic investigation. Am J Obstet Gynecol 190:1234–1240
Baker KR, Drutz HP, Barnes MD (1991) Effectiveness of antibiotic prophylaxis in preventing bacteriuria after multichannel urodynamic investigations: a blind, randomized study in 124 female patients. Am J Obstet Gynecol 165(3):679–681
Sabanathan K, Duffin HM, Castleden CM (1985) Urinary tract infection after cystometry. Age Ageing 14:291–295
Porru D, Madeddu G, Campus G, Montisci I, Scarpa RM, Usai E (1999) Evaluation of morbidity of multi-channel pressure–flow studies. Neurourol Urodyn 18:647–652
Harari D, Malone-Lee J, Ridgway GL (1994) An age-related investigation of urinary tract symptoms and infection following urodynamic studies. Age Ageing 23:62–64
Bombieri L, Dance DAB, Reinhardt GW, Waterfield A, Freeman RM (1999) Urinary tract infection after urodynamic studies in women: incidence and natural history. BJU Int 83:392–395
Klingler HC, Madersbacher S, Djavan B, Schatzl G, Marberger M, Schmidbauer CP (1998) Morbidity of the evaluation of the lower urinary tract with transurethral multichannel pressure–flow studies. J Urol 159:191–194
Cundiff GW, McLennan MT, Bent AE (1999) Randomized trial of antibiotic prophylaxis for combined urodynamics and cystourethroscopy. Obstet Gynecol 93:749–752
Burman WJ, Breese PE, Murray BE, Singh KV, Batal HA, MacKenzie TD, Ogle JW, Wilson ML, Reves RR, Mehler PS (2003) Conventional and molecular epidemiology of trimethoprim-sulfamethoxazole resistance among urinary Escherichia coli isolates. Am J Med 115:358–364
Peschers UM, Kempf V, Jundt K, Autenrieth I, Dimpfl T (2001) Antibiotic treatment to prevent urinary tract infections after urodynamic evaluation. Int Urogynecol J 12(4):254–257
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Lowder, J.L., Burrows, L.J., Howden, N.L.S. et al. Prophylactic antibiotics after urodynamics in women: a decision analysis. Int Urogynecol J 18, 159–164 (2007). https://doi.org/10.1007/s00192-006-0121-y
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DOI: https://doi.org/10.1007/s00192-006-0121-y