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- Title
What is the ideal antibiotic prophylaxis for intravesically administered Botox injection? A comparison of two different regimens.
- Authors
Houman, Justin; Moradzadeh, Ariel; Patel, Devin N.; Asanad, Kian; Anger, Jennifer T.; Eilber, Karyn S.
- Abstract
Introduction: Onabotulinum toxin A (Botox®) administered intravescially is an effective treatment for idiopathic detrusor overactivity, of which urinary tract infections (UTIs) are a common complication. The purpose of this study was to compare two prophylactic antibiotic regimens with the goal of decreasing UTI rates following intravesically administered Botox® injection. Materials and methods: A retrospective review of two groups of patients undergoing intravesically administered Botox® injections was performed—one with idiopathic and one with neurogenic detrusor overactivity. One group received a dose of ceftriaxone intramuscularly (IM) at the time of Botox® injection, and a second group received a 3-day course of a fluoroquinolone orally starting the day before the procedure. The rate of postprocedure UTI was examined using a χ2 test. A secondary analysis was performed using logistic regression modeling to test the association between clinical characteristics and antibiotic regimen and risk of postprocedure UTIs. Results: Botox® injections were performed on 284 patients: 236 received a single dose of ceftriaxone IM and 48 received 3 days of a fluoroquinolone orally. The UTI rate was significantly lower in the fluoroquinolone group (20.8%) vs. the cephalosporin group (36%), p = 0.04. Predictors of postprocedure UTIs included single dose of antibiotics IM [odds ratio (OR 2.80, p = 0.02] and a positive preprocedure urine culture (OR 1.31, p = 0.03). Conclusions: We found a significantly lower rate of UTIs when patients received a 3-day course of a fluoroquinolone orally as opposed to a single dose of a third-generation cephalosporin IM. Patients with a positive preprocedure culture might benefit from an even longer duration of antibiotics at the time of Botox® injection.
- Subjects
ANTIBIOTIC prophylaxis; URINARY tract infections; INJECTIONS; THERAPEUTICS; LOGISTIC regression analysis; ODDS ratio
- Publication
International Urogynecology Journal, 2019, Vol 30, Issue 5, p701
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-018-3721-4