1351. MULTIFACETED MANAGEMENT OF CATHETER-ASSOCIATED URINARY TRACT INFECTION IN PATIENTS WITH SPINAL CORD INJURY
Session: Poster Abstract Session: Clinical Trials
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background:  Management of catheter-associated urinary tract infections (CA-UTI) in patients with spinal cord injury (SCI) is non-standardized. The current project assesses the applicability of a multifaceted approach for managing CA-UTI in this population.

Methods: We conducted a randomized, controlled, non-inferiority clinical trial in SCI patients who had CA-UTI at the Michael E. DeBakey Veterans Affairs Medical Center. Patients were randomized to receive either a 5-day regimen of antibiotics  after catheter exchange, or a 10-day regimen of antibiotics with catheter retention.

Results: A total of 61 patients were enrolled in the study. Six patients were excluded because of bacteremia or absence of urinary symptoms. All patients (100%) achieved clinical cure at end of therapy (EOT). Patients who were treated with a 5-day course of antibiotics after catheter exchange had a lower rate of microbiologic response compared to those treated with a 10-day course with catheter retention (82.1% vs. 88.9%, 1-sided 95% CI for difference [-0.26, ∞]). There was no difference in the clinical cure or microbiologic response among patients who received fluroquinolones and those who did not. The rates of CA-UTI recurrence, new CA-UTI, diarrhea and C. difficile colitis were similar between the two treatment arms. 

Conclusion: A multifaceted approach including a 5-day antibiotic therapy with catheter exchange was non-inferior in clinical cure to a 10-day regimen with catheter retention, for management of SCI patients with CA-UTI.

Mayar Al Mohajer, MD, Michael E Debakey VA Medical Center-Baylor College of Medicine, Houston, TX, Danish Siddiq, MD, Medicine, Baylor College of Medicine, Houston, TX, Charles Minard, PhD, Dan L. Duncan Institute for Clinical & Translational Research, Baylor College of Medicine, Houston, TX and Rabih Darouiche, MD, Baylor College of Medicine, Houston, TX

Disclosures:

M. Al Mohajer, None

D. Siddiq, None

C. Minard, None

R. Darouiche, None

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