Skip Navigation



JAC Advance Access published online on February 10, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl010
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
57/4/784    most recent
dkl010v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Salomon, J.
Right arrow Articles by Bernard, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Salomon, J.
Right arrow Articles by Bernard, L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received August 17, 2005
Revised December 13, 2005
Accepted December 27, 2005

Brief report

Prevention of urinary tract infection in spinal cord-injured patients: safety and efficacy of a weekly oral cyclic antibiotic (WOCA) programme with a 2 year follow-up--an observational prospective study

Jérôme Salomon 1, Pierre Denys 2, Corinne Merle 1, Emmanuel Chartier-Kastler 2, Christian Perronne 1, Jean-Louis Gaillard 3, and Louis Bernard 1 *

1 Division of Infectious Diseases, Raymond Poincaré University Hospital (AP-HP), Garches, France
2 Department of Physical Medicine and Rehabilitation, Raymond Poincaré University Hospital (AP-HP), Garches, France
3 Microbiological Unit, Raymond Poincaré University Hospital (AP-HP), Garches, France

* To whom correspondence should be addressed.
Louis Bernard, E-mail: louis.bernard{at}rpc.aphp.fr


  Abstract

Population: Spinal cord injury (SCI) patients with neurogenic bladder have an increased risk for symptomatic urinary tract infection (UTI). Recurrent UTI requires multiple courses of antibiotic therapy, markedly increasing the incidence of multidrug-resistant (MDR) bacteria.

Methods: During an observational prospective study, we determined the safety and efficacy of a weekly oral cyclic antibiotic (WOCA) regimen to prevent UTI in SCI adult patients with neurogenic bladder undergoing clean intermittent catheterization. The WOCA regimen consisted of the alternate administration of an antibiotic once per week over a period of at least 2 years. The antibiotics chosen were efficient for UTI, well tolerated and with low selection pressure.

Results: There was a significant decrease in antimicrobial consumption linked to the dramatic decrease in the incidence of UTI. Before intervention, there were 9.4 symptomatic UTIs per patient-year, including 197 episodes of febrile UTI responsible for 45 hospitalizations. Under the WOCA regimen there were 1.8 symptomatic UTI per patient-year, including 19 episodes of febrile UTI. No severe adverse events and no new cases of colonization with MDR bacteria were reported.

Conclusions: In this prospective, observational pilot study a novel approach to the prevention and treatment of UTI in SCI was investigated. Our study shows the benefit of WOCA in preventing UTI in SCI patients.

Keywords: UTIs; antibiotic therapy; antibiotic prescription; antimicrobial susceptibility; healthcare-associated infections; infection control.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.