Article

The objective of this study was to compare the safety, efficacy,
quality-of-life impact, and costs of a single dose or a longer course of
pre-procedural antibiotics prior to elective endoscopic urological procedures in
individuals with spinal cord injury and disorders (SCI/D) and asymptomatic
bacteriuria. Design A prospective observational study. Setting Hunter Holmes
McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA. Participants
Sixty persons with SCI/D and asymptomatic bacteriuria scheduled to undergo
elective endoscopic urological procedures. Interventions A single pre-procedural
dose of antibiotics vs. a 3-5-day course of pre-procedural antibiotics. Outcome
measures Objective and subjective measures of health, costs, and quality of life.
Results There were no significant differences in vital signs, leukocytosis,
adverse events, and overall satisfaction in individuals who received short-course
vs. long-course antibiotics. There was a significant decrease in antibiotic cost
(33.1 +/- 47.6 vs. 3.6 +/- 6.1 US$, P = 0.01) for individuals in the short-course
group. In addition, there was greater pre-procedural anxiety (18 vs. 0%, P <
0.05) for individuals who received long-course antibiotics. Conclusion SCI/D
individuals with asymptomatic bacteriuria may be able to safely undergo most
endoscopic urological procedures with a single dose of pre-procedural
antibiotics. However, further research is required and even appropriate
pre-procedural antibiotics may not prevent severe infections.

Langue : ANGLAIS