Management of febrile urinary tract infection among spinal cord injured patients

• Published in: BMC infectious diseases Vol. 16; no. 153; p. 156
• Main Authors: Dinh, Aurélien, Toumi, Adnène, Blanc, Constance, Descatha, Alexis, Bouchand, Frédérique, Salomon, Jérôme, Hanslik, Thomas, Bernuz, Benjamin, Denys, Pierre, Bernard, Louis
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16-04-2016; BioMed Central
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Antibiotics; Care and treatment; Cohort Studies; Complications and side effects; Drug Therapy, Combination; Enterococcus - isolation & purification; Escherichia coli - isolation & purification; Female; Health aspects; Humans; Infectious diseases; Intensive Care Units; Male; Middle Aged; Pseudomonas aeruginosa - isolation & purification; Retrospective Studies; Risk factors; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - diagnosis; Urinary Bladder, Neurogenic - complications; Urinary tract infections; Urinary Tract Infections - complications; Urinary Tract Infections - drug therapy; Urinary Tract Infections - microbiology; Urinary tract infection; Neurogenic bladder; Antibiotic treatment duration
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-016-1484-4

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.
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.
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).
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.