Management of febrile urinary tract infection among spinal cord injured patients

BMC Infectious Diseases, 2016 · DOI: 10.1186/s12879-016-1484-4 · Published: April 4, 2016

Simple Explanation

Urinary tract infections (UTIs) are a common problem for people with neurogenic bladder, often leading to hospitalization. This study looked at how different durations of antibiotic treatment affected the cure rate of febrile UTIs in these patients. The study divided patients into three groups based on how long they received antibiotic treatment: less than 10 days, 10 to 15 days, and more than 15 days. The researchers then compared how well the treatments worked in each group. The results showed that there was no significant difference in cure rates between the three treatment duration groups. This suggests that shorter courses of antibiotics may be just as effective as longer courses for treating febrile UTIs in patients with neurogenic bladder.

Study Duration

2008 to 2013 (6 years)

Participants

112 cases of febrile UTI among 94 patients with neurogenic bladder

Evidence Level

Retrospective cohort study

Key Findings

1
There was no statistically significant difference in cure rates between the three antibiotic treatment duration groups (<10 days, 10-15 days, >15 days).
2
No significant difference in cure rate was observed between patients receiving monotherapy (one antibiotic) and those receiving dual therapy (two antibiotics).
3
The most commonly prescribed antibiotics were third-generation cephalosporins, aminoglycosides, and fluoroquinolones.

Research Summary

This retrospective study evaluated the impact of antibiotic treatment duration and monotherapy versus dual therapy on the cure rate of febrile UTIs in patients with neurogenic bladder. The study found no significant difference in cure rates based on antibiotic treatment duration (less than 10 days, 10-15 days, or more than 15 days) or whether monotherapy or dual therapy was used. The authors suggest that shorter antibiotic treatment durations and monotherapy may be sufficient for managing febrile UTIs in this patient population, potentially reducing the risk of antibiotic resistance and toxicity. They recommend a randomized control trial to confirm these findings.

Practical Implications

Shorter Treatment Durations

The study supports the use of shorter antibiotic courses (less than 10 days) for febrile UTIs in patients with neurogenic bladder, which may help reduce antibiotic resistance and toxicity.

Monotherapy Consideration

Monotherapy may be as effective as dual therapy for treating these infections, potentially avoiding the risks associated with multiple antibiotics.

Need for Randomized Trials

The findings highlight the need for randomized controlled trials to confirm these results and establish optimal treatment guidelines for febrile UTIs in patients with neurogenic bladder.

Study Limitations

1
Non-randomized trial, treatment duration was based on subjective criteria.
2
Several patients were lost to follow-up or required antibiotics for other reasons, introducing potential bias.
3
Heterogeneous patient population with various neurological deficits and voiding practices.

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