Pre-procedural antibiotics for endoscopic urological procedures: Initial experience in individuals with spinal cord injury and asymptomatic bacteriuria

Abstract

ObjectiveThe objective of this study was to compare the safety, efficacy, quality-of-life impact, and costs of a single dose or a longer course of pre-procedural antibiotics prior to elective endoscopic urological procedures in individuals with spinal cord injury and disorders (SCI/D) and asymptomatic bacteriuria.DesignA prospective observational study.SettingHunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA.ParticipantsSixty persons with SCI/D and asymptomatic bacteriuria scheduled to undergo elective endoscopic urological procedures.InterventionsA single pre-procedural dose of antibiotics vs. a 3–5-day course of pre-procedural antibiotics.Outcome measuresObjective and subjective measures of health, costs, and quality of life.ResultsThere were no significant differences in vital signs, leukocytosis, adverse events, and overall satisfaction in individuals who received short-course vs. long-course antibiotics. There was a significant decrease in antibiotic cost (33.1 ± 47.6 vs. 3.6 ± 6.1 US$, P = 0.01) for individuals in the short-course group. In addition, there was greater pre-procedural anxiety (18 vs. 0%, P < 0.05) for individuals who received long-course antibiotics.ConclusionSCI/D individuals with asymptomatic bacteriuria may be able to safely undergo most endoscopic urological procedures with a single dose of pre-procedural antibiotics. However, further research is required and even appropriate pre-procedural antibiotics may not prevent severe infections.