"Antibiotic Use, Best Practice Statement Adherence, and UTI Rate for In" by Katherine Shapiro, Monica van Til et al.
 

Antibiotic Use, Best Practice Statement Adherence, and UTI Rate for Intradetrusor Onabotulinumtoxin A Injection For Overactive Bladder: A Multi-Institutional Collaboration From the SUFU Research Network

Document Type

Conference Proceeding

Publication Date

4-2023

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: Onabotulinumtoxin A (BTX-A) is a well-established treatment for overactive bladder (OAB).The American Urological Association (AUA) 2008 Antibiotic Best Practice Statement recommended trimethoprim-sulfamethoxazole or fluoroquinolone for cystoscopy with manipulation. The aim of the study was to evaluate concordance with antibiotic best practices at the time of BTX-A injection and urinary tract infection (UTI) rates based on antibiotic regimen. METHODS: We included men and women undergoing first-time BTX-A injection for idiopathic OAB with 100 units in 2016 within the SUFU Research Network multi-institutional retrospective database. Patients on suppressive antibiotics were excluded. The primary outcome was concordance of periprocedural antibiotic use with the AUA 2008 Best Practice Statement. As a secondary outcome we compared the incidence of UTI at 15 days and 30 days after BTX-A among women. 15 days was used as a cutoff for a UTI attributed to BTX-A injection procedure, whereas a UTI within 30 days was considered a chronic effect of BTX-A. We assumed that patients who were not seen in the first 15 days did not have a UTI within 15 days. Fisher's exact tests were applied for categorical variables. RESULTS: Of the cohort of 216 patients (175 women, 41 men)undergoing BTX-A, 24 different periprocedural antibiotic regimens were utilized. Among patients who had in-office visits within 15 days of BTX-A, 87% received periprocedural antibiotics and 47% received best practice statement-concordant antibiotics. There was no significant difference in UTI events between patients who received any antibiotics and those that did not at 15 day follow up (N=173, 6% vs 9%, p=0.4). Of patients who received antibiotics, UTI rates did not vary significantly depending on concordance with recommendations or not (N=133, 5% vs 7%, p=0.7). 81% of the 216 patients with 30-day follow up received periprocedural antibiotics. Of those, 47%received best practice statement-concordant antibiotics. At 30 days, there was no significant difference in UTI events based on antibiotic use (N=173, 11% antibiotics vs 16% no antibiotics, p=0.5) or best practice statement concordance or not 8% vs 16% (N=133, p=0.13). CONCLUSIONS: This retrospective multi-institutional study demonstrates that antibiotic regimens and adherence to the AUA Best Practice Statement was variable among providers and that UTI rates at 15 or 30 days following BTX-A did not vary significantly regardless of antibiotic use or alignment with best practices

Volume

209

Issue

4S

First Page

e266

Comments

American Urological Association Annual Meeting, April 28 - May 1, 2023, Chicago, IL

DOI

10.1097/JU.0000000000003244.06

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