ARE PROPHYLACTIC

ANTIBIOTICS
NECESSARY WITH
CLEAN INTERMITTEN
CHATHETERIZATION ?

INTRODUCTION

CIC
Aims

described 1 century ago

prevent high RV
reduce UTI
Urology
prophylactic AB [UTI]
Previosly
little difference in
infection

PATIENTS AND METHOD

Patient 120 CIC, 85 agree

Group A continue AB
Group B would not AB
Lost follow up : 4 patients
Excluded,did not comply : 28
patients
Trial : 4 month

Clinical symptoms:
Fever
Nausea
Vomiting
Abd.pain
If group B infection restarting
prophylactic

PATIENT & DEMOGRAPHYCS

All patients single consultant

Catheter
polyvinyl cloride
coated polyvinylpyrrolidone
Size
8F to 16F
All patients CIC

Most patients spina

bifida,myelomeningocele
2 [A] & 3 [B] idiopathic
neurophatic bladder
Mean age [A] : 12,65 2,1 years
Mean age [B] : 11,89 2,3 years
Age no significant difference
p=1

RESULT

31patients [A] 11 [36%] infection

free
10 [91%] self cath.
1 [9%] non self
20 [64%] clinical
urine infection
14 [70%] non self
6 [30%] self cath.

22 patients [B] 19 [86%] infection

free
3 [14%] clinical
urine infection
Group A : 20 [64%] clinical UTI
Group B : 3 [14%] clinical UTI

The most inf.organism :

E.Coli,Psedomonas,Klebsiella,Enterob
acteria,Candida

DISCUSSION

CIC Lapides 1972

management neurophatic
bladder,myelomeningocele
enteric org. from GIT
AB did not eradicate bacteriuria
did not prevent UTI
Supressi AB : development various
resistant bacterial

Current series : UTI higher in

continued AB
Sex & age
: no defference UTI

CONCLUSION

Prophylactic AB not necessary

increase infection
resistant strains
developing