Prevention of urinary tract infection in six spinal cord-injured pregnant women who gave birth to seven children under a weekly oral cyclic antibiotic program.
BACKGROUND
Pregnancies in spinal cord-injured (SCI) patients present unique clinical challenges. Because of the neurogenic bladder and the use of intermittent catheterization, chronic bacteriuria and recurrent urinary tract infection (UTI) is common. During pregnancy the prevalence of UTI increases dramatically. Recurrent UTI requires multiple courses of antibiotics and increases the risks of abortion, prematurity, and low birth weight. A weekly oral cyclic antibiotic (WOCA) program was recently described for the prevention of UTI in SCI patients.


OBJECTIVE
To test the impact of WOCA in six SCI pregnant women (four paraplegic, two tetraplegic).


METHODS
This was a prospective observational study. WOCA consists of the alternate administration of one of two antibiotics once per week.


RESULTS
We observed a significant reduction of UTI (6 UTI/patient/year before pregnancy to 0.4 during pregnancy and under WOCA; p<0.001) and no obstetric complications. Infant outcomes were good.


CONCLUSIONS
The WOCA regimen could be useful for UTI prophylaxis in SCI pregnant women.
Salomon
Jérôme
J
INSERM U657, PhEMI, Institut Pasteur, Paris, France. jerome.salomon@rpc.aphp.fr
Schnitzler
Alexis
A
Ville
Yves
Y
Laffont
Isabelle
I
Perronne
Christian
C
Denys
Pierre
P
Bernard
Louis
L
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology* / Q000652:urine; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D047929:Term Birth; D014552:Urinary Tract Infections / Q000517:prevention & control*
D000900:Anti-Bacterial Agents