Antibiotic prophylaxis for urodynamic testing in women: a systematic review

Int Urogynecol J. 2021 Jan;32(1):27-38. doi: 10.1007/s00192-020-04501-3. Epub 2020 Aug 26.

Abstract

Introduction and hypothesis: Urinary tract infection is the most common complication after urodynamic studies (UDS). Practice guidelines recommend against antibiotic prophylaxis based on an outdated review of the literature, which advised on the premise of "a lack of good quality studies" and based on an assumed low incidence not consistently supported by the literature.

Objectives: This systematic review aims to update the assessment of the efficacy of antibiotic prophylaxis compared with placebo or no treatment for prevention of urinary tract infection in females over the age of 18 years undergoing UDS.

Methods: MEDLINE, EMBASE, COCHRANE, DISSERTATIONS, conference proceedings and clinical trial registries were searched for relevant randomized controlled trials. Two authors independently screened and selected articles, assessed these for quality according to Cochrane guidelines and extracted their data.

Results: A total of 2633 records were screened, identifying three relevant randomized controlled trials. The one study that was critically appraised as being the least likely biased showed a statistically significant effect of antibiotic prophylaxis in reducing bacteriuria post UDS in female patients. The other two studies included in the review did not. None of the studies included were powered to show a significant change in the incidence of urinary tract infection following UDS in female patients receiving antibiotic prophylaxis versus no prophylaxis.

Conclusions: Similar to the 2012 Cochrane review on this subject, this systematic review demonstrated that antibiotic prophylaxis may decrease bacteriuria in women post UDS; however, further research is required to assess its effect on urinary tract infections in this context.

Keywords: Antibiotic prophylaxis; Systematic review; Urinary tract infection; Urodynamics; Women.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis
  • Bacteriuria* / prevention & control
  • Female
  • Humans
  • Middle Aged
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / prevention & control
  • Urodynamics

Substances

  • Anti-Bacterial Agents