You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction1 Apr 2016MP17-15 BACTERIURIA IN PATIENTS UNDERGOING INTRADETRUSOR ONABOTULINUMTOXINA INJECTIONS FOR REFRACTORY NEUROGENIC DETRUSOR OVERACTIVITY: DO WE NEED ANTIBIOTIC PROPHYLAXIS? Lorenz Leitner, Ulla Sammer, Matthias Walter, Stephanie Knüpfer, Marc P. Schneider, Burkhardt Seifert, Ulrich Mehnert, and Thomas M. Kessler Lorenz LeitnerLorenz Leitner More articles by this author , Ulla SammerUlla Sammer More articles by this author , Matthias WalterMatthias Walter More articles by this author , Stephanie KnüpferStephanie Knüpfer More articles by this author , Marc P. SchneiderMarc P. Schneider More articles by this author , Burkhardt SeifertBurkhardt Seifert More articles by this author , Ulrich MehnertUlrich Mehnert More articles by this author , and Thomas M. KesslerThomas M. Kessler More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2683AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Intradetrusor onabotulinumtoxinA injections is a highly effective, minimally invasive and well-tolerated therapy for refractory neurogenic detrusor overactivity (NDO). Many of these patients rely on some type of catheterisation and present with chronic bacteriuria. In these patients, antibiotic prophylaxis has been widely recommended since bacteriuria might impair efficacy and cause urinary tract infection (UTI), but the evidence is very limited. Thus, the aim of the present study was to evaluate if an antibiotic prophylaxis is needed in patients with bacteriuria undergoing intradetrusor onabotulinumtoxinA injections. METHODS Between 06/2012 and 12/2014, a consecutive series of 154 patients undergoing a total of 273 treatments with intradetrusor onabotulinumtoxinA injections for refractory NDO were prospectively evaluated. Before treatment, urine samples were collected by sterile catheterisation for urinalysis and culture. Patients with no clinical signs for UTI underwent intradetrusor onabotulinumtoxinA injections and no antibiotic prophylaxis was given. Efficacy and safety of intradetrusor onabutulinumtoxinA injections were assessed and compared between patients with and without bacteriuria prior treatment. RESULTS Bacteriuria was found in 73% (200/273) prior intradetrusor onabotulinumtoxinA injections. Following treatment, UTI occurred in 7% (5/73) of cases with sterile urine culture and in 5% (9/200) with bacteriuria. 2 patients were hospitalised because of febrile UTI, both showed no bacteriuria before treatment. One patient with pre-treatment bacteriuria suffered from prolonged, but self-limiting gross haematuria. Intradetrusor onabotulinumtoxinA injections were clinically and urodynamically successful in 70% (192/273). The treatment effect lasted for a mean of 10 months and was similar (p=0.56) in patients with (12±15 months) and without (10±12 months) bacteriuria. In addition, no association between bacteriuria and treatment-related adverse events (odds ratio 0.64, 95% confidence interval (CI) 0.23-1.81, p=0.4), nor for therapy failure (odds ratio 0.78, 95% CI 0.43-1.43, p=0.4) was detected. CONCLUSIONS Bacteriuria in patients undergoing intradetrusor onabotulinumtoxinA injections for refractory NDO did not affect efficacy and safety outcomes. Thus, antibiotic prophylaxis seems not to be justified and needs to be critically reconsidered, especially taking into account the alarming antibiotic resistance worldwide. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e189-e190 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Lorenz Leitner More articles by this author Ulla Sammer More articles by this author Matthias Walter More articles by this author Stephanie Knüpfer More articles by this author Marc P. Schneider More articles by this author Burkhardt Seifert More articles by this author Ulrich Mehnert More articles by this author Thomas M. Kessler More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...