Prevention of urinary tract infection in six spinal cord-injured pregnant women who gave birth to seven children under a weekly oral cyclic antibiotic program

Salomon, Jérôme; Schnitzler, Alexis; Ville, Yves; Laffont, Isabelle; Perronne, Christian; Denys, Pierre; Bernard, Louis

doi:10.1016/j.ijid.2008.08.006

« Previous Next »International Journal of Infectious Diseases
Volume 13, Issue 3 , Pages 399-402, May 2009

Prevention of urinary tract infection in six spinal cord-injured pregnant women who gave birth to seven children under a weekly oral cyclic antibiotic program

Jérôme Salomon
- INSERM U657, PhEMI, Institut Pasteur, Paris, France
- Department of Infectious Diseases, AP-HP, CHU Raymond Poincaré, Versailles University, 104 Boulevard Raymond Poincaré, F-92 380 Garches, France
- Corresponding author. Tel.: +33 1 47 10 77 60; fax: +33 1 47 10 77 67.
Alexis Schnitzler
- Department of Physical Medicine and Rehabilitation, AP-HP, Hôpital Poincaré, Versailles University, Garches, France
Yves Ville
- Department of Obstetrics and Gynecology, Hôpital de Poissy, Versailles University, Garches, France
Isabelle Laffont
- Department of Physical Medicine and Rehabilitation, AP-HP, Hôpital Poincaré, Versailles University, Garches, France
Christian Perronne
- Department of Infectious Diseases, AP-HP, CHU Raymond Poincaré, Versailles University, 104 Boulevard Raymond Poincaré, F-92 380 Garches, France
Pierre Denys
- Department of Physical Medicine and Rehabilitation, AP-HP, Hôpital Poincaré, Versailles University, Garches, France
Louis Bernard
- Department of Infectious Diseases, AP-HP, CHU Raymond Poincaré, Versailles University, 104 Boulevard Raymond Poincaré, F-92 380 Garches, France

Received 29 February 2008; received in revised form 23 July 2008; accepted 1 August 2008. published online 05 November 2008.

Corresponding Editor: Michael Whitby, Brisbane, Australia

Summary

Background

Pregnancies in spinal cord-injured (SCI) patients present unique clinical challenges. Because of the neurogenic bladder and the use of intermittent catheterization, chronic bacteriuria and recurrent urinary tract infection (UTI) is common. During pregnancy the prevalence of UTI increases dramatically. Recurrent UTI requires multiple courses of antibiotics and increases the risks of abortion, prematurity, and low birth weight. A weekly oral cyclic antibiotic (WOCA) program was recently described for the prevention of UTI in SCI patients.

Objective

To test the impact of WOCA in six SCI pregnant women (four paraplegic, two tetraplegic).

Design

This was a prospective observational study. WOCA consists of the alternate administration of one of two antibiotics once per week.

Results

We observed a significant reduction of UTI (6 UTI/patient/year before pregnancy to 0.4 during pregnancy and under WOCA; p<0.001) and no obstetric complications. Infant outcomes were good.