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


M. Al Mohajer, None

D. Siddiq, None

C. Minard, None

R. Darouiche, None

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