Language
English
Publication Date
5-1-2025
Journal
The Journal of Spinal Cord Medicine
DOI
10.1080/10790268.2024.2311348
PMID
38391262
PMCID
PMC12035924
PubMedCentral® Posted Date
2-23-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Context/objective: Despite urinary tract infections (UTIs) being a common problem in patients with spinal cord injuries (SCIs), and a well-known complication of invasive urologic procedures, little consensus exists regarding the standard of care for peri-procedural antibiotic use for SCI patients undergoing urodynamics studies (UDS). Our research seeks to evaluate local antibiotic prophylaxis pattern in SCI patients undergoing UDS, assess incidence of post-procedural UTI, describe local antibiotic resistance trends, and provide antibiotic stewardship considerations to guide future practice.
Design/setting/participants: Retrospective cohort study of SCI patients undergoing UDS from January 2010 to January 2020 at a Veterans Affairs SCI Center. Data on patient demographics, UTI risk factors, pre-procedural urinalysis and culture, and peri-procedural antibiotics was extracted. Incidence of post-procedural UTI was tabulated. Findings were summarized using descriptive statistics.
Results: 331 patients were studied. Pre-procedural urine culture was done in 73% of cases, with positive results in 49%. E. coli was the most commonly isolated organism (19%). Antibiotics were used in 86% of cases, 26% of which had a negative culture. A onetime dose of intramuscular gentamicin given immediately pre-procedure was the most common practice (53%; N = 152). No cases of post-procedural UTIs were identified during the study period.
Conclusion: No post-UDS UTIs occurred under current local practice where most patients received a one-time dose of intramuscular gentamicin as prophylaxis. Though routine gentamicin prophylaxis may play a role in reducing UTI incidence, the low rate of post-UDS UTI in this population, including patients with positive cultures who received no antibiotics, suggests the possibility of refining practice patterns to improve antibiotic stewardship.
Keywords
Humans, Spinal Cord Injuries, Male, Female, Urinary Tract Infections, Antibiotic Prophylaxis, Middle Aged, Retrospective Studies, Urodynamics, Adult, Aged, Anti-Bacterial Agents, Practice Patterns, Physicians', Antimicrobial Stewardship, Spinal cord injury, Urinary tract infection, Urodynamics, Antibiotic prophylaxis
Published Open-Access
yes
Recommended Citation
Pham, Du; Chi, Bradley; Skelton, Felicia; et al., "Antibiotic Prophylaxis With Urodynamic Studies in Spinal Cord Injury: Assessing Practice Patterns and Outcomes To Guide Future Practice in a Single Center" (2025). Faculty and Staff Publications. 4594.
https://digitalcommons.library.tmc.edu/baylor_docs/4594