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Antibiotic prophylaxis in invasive urodynamics, a Delphi consensus of the Italian Society of Urodynamics (SIUD).
Rubilotta, Emanuele; Chiarulli, Elisabetta F; Ammirati, Enrico; Bevacqua, Marianna C; Manodoro, Stefano; Chierchia, Stefania; Fragalà, Eugenia; Masiello, Giuseppe; Li Marzi, Vincenzo; Giammò, Alessandro; Musco, Stefania; Savoca, Francesco; Balzarro, Matteo; De Nunzio, Cosimo; De Rienzo, Gaetano; Fusco, Ferdinando; Lamberti, Gianfranco; Soligo, Marco; De Palma, Luisa; Fasano, Massimo; Carretta, Anna; Tumietto, Fabio; Finazzi-Agrò, Enrico; Russo, Eleonora; Antonelli, Alessandro; Gubbiotti, Marilena; Sampogna, Gianluca; Spinelli, Michele; Carone, Roberto; Martino, Leonardo; Mancini, Vito.
Afiliação
  • Rubilotta E; Department of Urology, Azienda Ospedaliera Universitaria Verona, Verona, Italy.
  • Chiarulli EF; UO Urologia, ASST-Rhodense (Rho) Milano, Torino, Italy.
  • Ammirati E; Neuro-Urologia, CTO Unità spinale unipolare, Città della Salute e della Scienza, Torino, Italy.
  • Bevacqua MC; UOC Urologia Abilitata al Trapianto, Grande Ospedale Metropolitano di Reggio Calabria, Milano, Italy.
  • Manodoro S; UO Ostetricia e Ginecologia Ospedale San Paolo, ASST Santi Paolo e Carlo, Milano, Italy.
  • Chierchia S; Neuro-Urologia, CTO Unità spinale unipolare, Città della Salute e della Scienza, Torino, Italy.
  • Fragalà E; UO Urologia Ospedale G.B. Morgagni - L. Pierantoni, AUSL Romagna, Forlì, Italy.
  • Masiello G; UO Urologia Ospedale Di Venere, Bari, Italy.
  • Li Marzi V; Unit of Urological Robotic Surgery and Renal Transplantation, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, Firenze, Italy.
  • Giammò A; UO Urologia, ASST-Rhodense (Rho) Milano, Torino, Italy.
  • Musco S; Unit of Neuro-Urology, Azienda Ospedaliera Careggi, Firenze, Italy.
  • Savoca F; Unit of Urology, Cannizzaro Hospital, Catania, Italy.
  • Balzarro M; Department of Urology, Azienda Ospedaliera Universitaria Verona, Verona, Italy.
  • De Nunzio C; Department of Urology, Sapienza University, Ospedale Sant'Andrea, Roma, Italy.
  • De Rienzo G; Urology and Andrology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
  • Fusco F; Dep. Urology, Ospedale di Caserta, Caserta, Italy.
  • Lamberti G; Dep. Rehabilitative Medicine, Azienda USL Piacenza, Piacenza, Italy.
  • Soligo M; Unit of Obstetrics and Gynecology, Ospedale Maggiore, Lodi, Italy.
  • De Palma L; UOC Medicina Fisica e Riabilitazione, Policlinico di Bari, Italy.
  • Fasano M; UO Malattie Infettive, Ospedale Perinei, Altamura, Bari, Italy.
  • Carretta A; UOC Malattie Infettive, Policlinico di Foggia, Foggia, Italy.
  • Tumietto F; UOC Stewardship Antimicrobica, AUSL, Bologna, Italy.
  • Finazzi-Agrò E; Department of Surgical Sciences, Urology Unit, University of Rome Tor Vergata, Roma, Italy.
  • Russo E; UO Ginecologia e Ostetricia Universitaria I Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
  • Antonelli A; Department of Urology, Azienda Ospedaliera Universitaria Verona, Verona, Italy.
  • Gubbiotti M; Dep. Urology, Montevarchi, Ospedale La Gruccia, Arezzo, Italy.
  • Sampogna G; Unipolar Spinal Unit and Neurourology Service, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
  • Spinelli M; Unipolar Spinal Unit and Neurourology Service, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
  • Carone R; Neurourology, Ospedale Koelliker, Torino, Italy.
  • Martino L; Urology Unit and Renal Transplantation, Policlinico di Foggia, Università di Foggia, Foggia, Italy.
  • Mancini V; Urology Unit and Renal Transplantation, Policlinico di Foggia, Università di Foggia, Foggia, Italy.
Neurourol Urodyn ; 43(5): 1192-1198, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38587242
ABSTRACT

INTRODUCTION:

Although antibiotic prophylaxis (AB) demonstrated a statistically significant reduction in bacteriuria after invasive urodynamics (UDS), no significant decrease in the incidence of urinary tract infections (UTI) has been confirmed. No absolute recommendations on the use of AB in case of relevant potential risk of UTI have been reported, though some categories of patients at increased infective probability after UDS have been recognized. The aim of this study is to report the experts' consensus on the best practice for the use of AB before UDS in the main categories of patients at potential risk of developing UTI. MATERIALS AND

METHODS:

A systematic literature review was performed on AB before UDS in males and females. A panel of experts from the Italian Society of Urodynamics, Continence, Neuro-Urology, and Pelvic Floor (SIUD) assessed the review data and decided by a modified Delphi method on 16 statements proposed and discussed by the panel. The cut-off percentage for the consensus was a ≥70% of positive responses to the survey. The study was a Delphi consensus with experts' opinions, not a clinical trial involving directly patients.

RESULTS:

The panel group was composed of 57 experts in functional urology and UDS, mainly urologists, likewise gynaecologists, physiatrists, infectivologists, pediatric urologists, and nurses. A positive consensus was achieved on 9/16 (56.25%) of the statements, especially on the need for performing AB before UD in patients with neurogenic bladder and immunosuppression. Urine analysis and urine culture before UDS are mandatory, and in the event of their positivity, UDS should be postponed. A consensus was reached on avoiding AB in menopausal status, diabetes, age, gender, bladder outlet obstruction, high postvoid residual, chronic catheterization, previous urological surgery, lack of urological abnormalities, pelvic organ prolapse, and negative urine analysis.

CONCLUSIONS:

Antibiotic prophylaxis is not recommended for patients without notable risk factors and with a negative urine test due to the potential morbidities that may result from antibiotic administration. However, AB can be used for risk categories such as neurogenic bladder and immunosuppression. The evaluation of urine analysis and urine culture and postponing UDS in cases of positive tests were considered good practices, as well as performing AB in the neurogenic bladder and immunosuppression.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Urinárias / Urodinâmica / Técnica Delphi / Antibioticoprofilaxia / Consenso Limite: Female / Humans / Male País/Região como assunto: Europa Idioma: En Revista: Neurourol Urodyn Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Urinárias / Urodinâmica / Técnica Delphi / Antibioticoprofilaxia / Consenso Limite: Female / Humans / Male País/Região como assunto: Europa Idioma: En Revista: Neurourol Urodyn Ano de publicação: 2024 Tipo de documento: Article