For a study, researchers sought to evaluate the effect of antibiotic prophylaxis duration on the incidence of urinary tract infection (UTI) following intravenous OnabotulinumtoxinA (BTX) injection.

An analysis of a retrospective cohort of individuals with OAB who had office-based BTX injections between 2014 and 2020. Three levels of antibiotic prophylaxis—no antibiotic, one day, or a multiday course—were examined for UTI incidence within 30 days after BTX. The relationship between UTI and BTX units, body mass index, a history of diabetes, immunosuppression, neurogenic hyperactive bladder, chronic catheter, or recurrent UTI was looked at.

There were 290 patients and 896 cycles of BTX injections; 877 injections (97.7%) were administered to women, with a mean age of 61.4 years (range 20-96; SD 13.3). About 112 (12.5%) patients did not receive antibiotic prophylaxis, 595 (66%) did not receive any, and 189 (21%) had a multiple-day course (3-7 days). Around 11.4% of people had a UTI within 30 days overall. Using multivariable logistic regression, there was no difference in the incidence of UTI between single and multiple-day regimens (OR 1.38; 95% CI 0.80-2.38; P=.249), and the use of any antibiotic prophylaxis was associated with a lower incidence of UTI (single OR 0.34; 95% CI 0.19-0.61; P<.001; multiple OR 0.47; 0.24-0.92; P=.029). Additional variables were a history of recurrent UTIs (OR 3.77; 95% CI 2.23-6.39; P<.001) and chronic suprapubic catheterization (OR 2.88; 95% CI 1.04-7.95; P=.041).

Antibiotic prophylaxis over several days was not any more effective than prophylaxis over one day in avoiding UTI for intravesical BTX injection. When compared to no antibiotic, the incidence of UTI was considerably reduced when any antibiotic was used as prophylaxis.