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Prophylactic antibiotics to prevent urinary tract infection during clean intermittent self-catheterization (CISC) for management of voiding dysfunction after prolapse and incontinence surgery: a decision analysis.

Abstract

INTRODUCTION AND HYPOTHESIS

The objective of this study is to estimate efficacy of prophylactic antibiotics in UTI prevention during CISC for postoperative voiding dysfunction after prolapse/incontinence surgery.

METHODS

We constructed a decision tree model to evaluate risks and benefits of prophylactic antibiotics during CISC for voiding dysfunction after prolapse/incontinence surgery. The model randomized women requiring CISC to prophylactic antibiotics or no prophylaxis. Probabilities for UTI after CISC with or without prophylactic antibiotics, sequelae from antibiotic use or UTI, and utility values were obtained from published literature and practice quality assurance reviews. Main outcome was probability of experiencing no UTI or adverse event.

RESULTS

Under baseline assumptions, prophylactic antibiotics were favored in both models. In the true UTI model, prophylactic antibiotics had an 83.1% probability of no UTI or adverse events; 16.1% better than no prophylactic antibiotics.

CONCLUSIONS

Using decision analysis methods, prophylactic antibiotics are favored for prevention of UTI during CISC to manage voiding dysfunction after prolapse/incontinence surgery.

Authors+Show Affiliations

Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh-School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19582384

Citation

Sutkin, Gary, et al. "Prophylactic Antibiotics to Prevent Urinary Tract Infection During Clean Intermittent Self-catheterization (CISC) for Management of Voiding Dysfunction After Prolapse and Incontinence Surgery: a Decision Analysis." International Urogynecology Journal and Pelvic Floor Dysfunction, vol. 20, no. 8, 2009, pp. 933-8.
Sutkin G, Lowder JL, Smith KJ. Prophylactic antibiotics to prevent urinary tract infection during clean intermittent self-catheterization (CISC) for management of voiding dysfunction after prolapse and incontinence surgery: a decision analysis. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(8):933-8.
Sutkin, G., Lowder, J. L., & Smith, K. J. (2009). Prophylactic antibiotics to prevent urinary tract infection during clean intermittent self-catheterization (CISC) for management of voiding dysfunction after prolapse and incontinence surgery: a decision analysis. International Urogynecology Journal and Pelvic Floor Dysfunction, 20(8), pp. 933-8. doi:10.1007/s00192-009-0885-y.
Sutkin G, Lowder JL, Smith KJ. Prophylactic Antibiotics to Prevent Urinary Tract Infection During Clean Intermittent Self-catheterization (CISC) for Management of Voiding Dysfunction After Prolapse and Incontinence Surgery: a Decision Analysis. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(8):933-8. PubMed PMID: 19582384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic antibiotics to prevent urinary tract infection during clean intermittent self-catheterization (CISC) for management of voiding dysfunction after prolapse and incontinence surgery: a decision analysis. AU - Sutkin,Gary, AU - Lowder,Jerry L, AU - Smith,Kenneth J, Y1 - 2009/04/10/ PY - 2009/01/07/received PY - 2009/03/29/accepted PY - 2009/7/8/entrez PY - 2009/7/8/pubmed PY - 2009/9/30/medline SP - 933 EP - 8 JF - International urogynecology journal and pelvic floor dysfunction JO - Int Urogynecol J Pelvic Floor Dysfunct VL - 20 IS - 8 N2 - INTRODUCTION AND HYPOTHESIS: The objective of this study is to estimate efficacy of prophylactic antibiotics in UTI prevention during CISC for postoperative voiding dysfunction after prolapse/incontinence surgery. METHODS: We constructed a decision tree model to evaluate risks and benefits of prophylactic antibiotics during CISC for voiding dysfunction after prolapse/incontinence surgery. The model randomized women requiring CISC to prophylactic antibiotics or no prophylaxis. Probabilities for UTI after CISC with or without prophylactic antibiotics, sequelae from antibiotic use or UTI, and utility values were obtained from published literature and practice quality assurance reviews. Main outcome was probability of experiencing no UTI or adverse event. RESULTS: Under baseline assumptions, prophylactic antibiotics were favored in both models. In the true UTI model, prophylactic antibiotics had an 83.1% probability of no UTI or adverse events; 16.1% better than no prophylactic antibiotics. CONCLUSIONS: Using decision analysis methods, prophylactic antibiotics are favored for prevention of UTI during CISC to manage voiding dysfunction after prolapse/incontinence surgery. UR - https://www.unboundmedicine.com/medline/citation/19582384/Prophylactic_antibiotics_to_prevent_urinary_tract_infection_during_clean_intermittent_self_catheterization__CISC__for_management_of_voiding_dysfunction_after_prolapse_and_incontinence_surgery:_a_decision_analysis_ L2 - https://ClinicalTrials.gov/search/term=19582384 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -