title: Management of febrile urinary tract infection among spinal cord injured patients.
abstract: BACKGROUND
  Urinary tract infection (UTI) among patients with neurogenic bladder is a major problem but its management is not well known. We studied the relationship between antibiotic regimen use and the cure rate of those infections among 112 patients with neurogenic bladder.
  
  
  METHODS
  We studied a retrospective cohort of febrile UTI among patients with neurogenic bladder. Drug selection was left to the discretion of the treating physicians, in accordance with current guidelines. Patients were divided into 3 groups according to antibiotic treatment duration (<10 days, between 10 and 15 days, and >15 days). We analysed clinical and microbiogical cure rate one month after the end of antibiotic treatment.
  
  
  RESULTS
  The three groups of patients were similar, especially in terms of drug treatment (equal distribution). The cure rates were not significantly different (71.4 %, 54.2 %, and 57.1 %, respectively; p = 0.34). Moreover, there was no difference in cure rate between mono and dual therapy (44 % for monotherapy vs. 40 % for dual therapy; p = 0.71).
  
  
  CONCLUSIONS
  This descriptive study supports the efficacy of antimicrobial treatment duration of less than 10 days and the use of monotherapy to treat febrile UTI among patients with neurogenic bladder. A randomized control trial is required to confirm these data.
authors.affiliation: Infectious Disease Unit, Garches PIFO University Hospital, AP-HP, Versailles Saint Quentin University, Garches, France. aurelien.dinh@aphp.fr.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Dinh
authors.affiliation: Infectious Diseases Unit, University Hospital, Monastir, Tunisia.
authors.forename: Adnène
authors.initials: A
authors.lastname: Toumi
authors.affiliation: Infectious Disease Unit, Garches PIFO University Hospital, AP-HP, Versailles Saint Quentin University, Garches, France.
authors.forename: Constance
authors.initials: C
authors.lastname: Blanc
authors.affiliation: Infectious Disease Unit, Garches PIFO University Hospital, AP-HP, Versailles Saint Quentin University, Garches, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Descatha
authors.affiliation: Pharmacy, University Hospital, AP-HP, Versailles Saint Quentin University, Garches, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Bouchand
authors.affiliation: Infectious Disease Unit, Garches PIFO University Hospital, AP-HP, Versailles Saint Quentin University, Garches, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Salomon
authors.affiliation: Internal Medicine Unit, University Hospital, AP-HP, Versailles Saint Quentin University, Boulogne-Billancourt, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hanslik
authors.affiliation: Physical Medicine and Rehabilitation Department, University Hospital, AP-HP, Versailles Saint Quentin University, Garches, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bernuz
authors.affiliation: Physical Medicine and Rehabilitation Department, University Hospital, AP-HP, Versailles Saint Quentin University, Garches, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Denys
authors.affiliation: Infectious Disease Unit, Bretonneau University Hospital, Tours, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Bernard
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D016983:Enterococcus / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis*; D001750:Urinary Bladder, Neurogenic / Q000150:complications; D014552:Urinary Tract Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic treatment duration; Neurogenic bladder; Urinary tract infection