Multi-day not better than single-day antibiotic at preventing UTI after BTX shot

Prophylactic antibiotic works to prevent the development of urinary tract infection (UTI) following intravesical OnabotulinumtoxinA (BTX) injection, with a multiple-day regimen being as effective as a single-day regimen, according to a study.

The study included 290 patients (mean age 61.4 years) with overactive bladder (OAB) who underwent 896 cycles of office BTX injections.

Researchers compared the incidence of UTI within 30 days of BTX among the following antibiotic prophylaxis exposures: no antibiotic, single-day, or multiple-day course. They also examined the association of UTI with units of BTX, body mass index, history of diabetes, immunosuppression, neurogenic OAB, chronic catheter, or recurrent UTI.

A total of 877 injections (97.7 percent) included in the analysis were for women. Most patients (n=595, 66 percent) received a single-day course of antibiotics, 189 (21 percent) received a multiple-day regimen (3–7 days), and 112 (12.5 percent) did not receive antibiotic prophylaxis.

The overall 30-day incidence of UTI was 11.4 percent. Multivariable logistic regression analysis indicated that compared with nonuse, the use of any antibiotic prophylaxis was associated with a lower likelihood of developing UTI (single day: odds ratio [OR], 0.34, 95 percent confidence interval [CI], 0.19–0.61; p<0.001; multiple day: OR, 0.47, 95 percent CI, 0.24–0.92; p=0.029).

Moreover, there was no significant difference in the odds of incident UTI seen between single- and multiple-day regimens (OR, 1.38, 95 percent CI, 0.80–2.38; p=0.249).

Predictors of incident UTI were history of recurrent UTI (OR, 3.77, 95 percent CI, 2.23–6.39; p<0.001) and chronic suprapubic catheter (OR, 2.88, 95 percent CI, 1.04–7.95; p=0.041).