title: Prospective evaluation of antibiotic treatment for urological procedure in patients presenting with neurogenic bladder.
abstract: OBJECTIVE
  Patients presenting with neurogenic bladder often require urological procedures (urodynamic testing and botulinum toxin injections) and a preventive antibiotic therapy. We aimed to assess the efficacy of this little known strategy in a cohort of patients.
  
  
  METHODS
  All patients presenting with neurogenic bladder who underwent urological procedure were included in the study. They received an antibiotic therapy in accordance with the urine cytobacteriological examination results. The antibiotic therapy was initiated two days before the procedure and prolonged up until two days after the procedure if the culture was positive. Patients were treated with a single dose of fosfomycin-trometamol in case of a negative culture. The main study outcome was the occurrence of urinary tract infection (UTI), defined by a positive urine culture and symptoms, up until 14 days after the procedure.
  
  
  RESULTS
  A total of 80 urological procedures were performed. Mean patient age was 47±13.1 years (sex ratio 1.22); 59 (73.8%) presented with asymptomatic bacteriuria before the procedure. Nine (11.1%) UTIs were recorded on Day 14, of which one (1.2%) was febrile. Two patients required an additional curative antibiotic therapy. No patient was hospitalized. Overall, 77.8% of UTIs were cured without antibiotic therapy.
  
  
  CONCLUSIONS
  Screening and treating asymptomatic bacteriuria before urological procedures seems unnecessary and vainly exposes this population at high risk of infectious diseases to antibiotic therapies. This data should be confirmed by a randomized clinical trial.
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité d'urodynamique, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: L
authors.initials: L
authors.lastname: Weglinski
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité des maladies infectieuses, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: C
authors.initials: C
authors.lastname: Rouzaud
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité d'urodynamique, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: A
authors.initials: A
authors.lastname: Even
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, département de pharmacie, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: F
authors.initials: F
authors.lastname: Bouchand
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité des maladies infectieuses, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: B
authors.initials: B
authors.lastname: Davido
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité des maladies infectieuses, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: C
authors.initials: C
authors.lastname: Duran
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité des maladies infectieuses, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: J
authors.initials: J
authors.lastname: Salomon
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité des maladies infectieuses, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: C
authors.initials: C
authors.lastname: Perronne
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité d'urodynamique, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: P
authors.initials: P
authors.lastname: Denys
authors.affiliation: AP-HP, université Pierre-et-Marie-Curie, hôpital universitaire Pitié Salpêtrière, service d'urologie, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Chartier-Kastler
authors.affiliation: AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité d'urodynamique, 104, boulevard R.-Poincaré, 92380 Garches, France; AP-HP, hôpital universitaire R.-Poincaré, université Versailles-Saint-Quentin, hôpitaux Paris Île-de-France Ouest, unité des maladies infectieuses, 104, boulevard R.-Poincaré, 92380 Garches, France. Electronic address: aurelien.dinh@aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Dinh
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D058070:Asymptomatic Diseases; D001437:Bacteriuria / Q000453:epidemiology / Q000382:microbiology; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications* / Q000188:drug therapy; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014563:Urodynamics; D014946:Wound Infection / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D019274:Botulinum Toxins, Type A
keywords: Bactéries multi-résistantes; Infection urinaire; Multidrug-resistant bacteria; Neurogenic bladder; Prophylaxie; Prophylaxis; Urinary tract infection; Vessie neurologique