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SUFU 2022: Efficacy of Antibiotic Prophylaxis Among Intermittent Catheter Users with Different Neurologic Diseases: A Secondary Analysis of the AnTIC Trial

(UroToday.com) This study was a secondary analysis of community dwelling participants to assess the relative reduction in UTIs among people with different neurologic diseases and intermittent catheter use and to determine if UTIs impacted renal function. Analyzed were those individuals who participated in a 12-month randomized trial (AnTIC, a multicentered, clinical trial carried out in the United Kingdom) of low-dose antibiotic prophylaxis. Primary analysis was measuring the incident rate ratio (IRR) of symptomatic UTIs that required antibiotics in the antibiotic prophylaxis group versus the non-prophylaxis group (usual care arm). Renal function was assessed at the beginning and end of the 12 months using the estimated glomerular filtration rate.

As to the presence of neurogenic disease, 38% (138/361) had a neurologic disease (multiple sclerosis (25%), spinal cord injury (SCI)(21%), spina bifida (18%), and other disorders (36%). The incidence of symptomatic, antibiotic treated urinary infections was 1.48 per person-year in the prophylaxis group, and 2.51 per person-year in the non-prophylaxis group; the IRR was 0.59 (95% CI 0.46, 0.76) in favor of continuous antibiotic prophylaxis. The IRR value for UTI risk was lowest (most protective) among those with SCI (IRR 0.23, p<0.01) and highest (least protective) in those with spina bifida (IRR 0.85, p=0.57). Small, non-significant decreases in renal function that occurred during the study did not differ based on randomization and no significant differences between pre- and post-study renal function among participants who had 0, 1, 2, or ≥3 UTIs.

These researchers concluded that continuous antibiotic prophylaxis may be more effective for certain patient populations with neurogenic diseases. Renal function was not significantly impacted by a higher number of UTIs over the course of one year but further study is needed.

Presented by: Blayne Welk,1 Holly Fisher,2 Thomas Chadwick,2 Chris Harding3

  1. Western University
  2. Population Health Sciences Institute, Newcastle University
  3. Department of Urology, Newcastle-upon-Tyne Hospitals
Written by: Diane K. Newman, DNP, ANP-BC, FAAN, Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health at the 2022 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Winter Meeting, February 22 - 26, 2022