Comparison of Methods for Prevention of Urinary Tract Infection Following Botox Injection

Last updated: October 31, 2023
Sponsor: Vanderbilt University Medical Center
Overall Status: Terminated

Phase

4

Condition

Urinary Tract Infections

Enuresis

Overactive Bladder

Treatment

Extended Antibiotics

Injection of OnabotulinumtoxinA (BTX-A)

Periprocedural Antibiotics

Clinical Study ID

NCT03508921
00011112222
  • Ages > 18
  • All Genders

Study Summary

Injection of OnabotulinumtoxinA (BTX-A) into the bladder is a widely used treatment option for patients with overactive bladder who have failed medical therapy. Urinary tract infection is the most common side effect of this procedure and therefore antibiotics are given around the time of injection in order to prevent these events. While antibiotics are commonly given at the time of injection, the duration of these antibiotic regimens are variable. The investigators propose a study to investigate different antibiotic protocols and their affect on the rate of urinary tract infection after injection.

Eligibility Criteria

Inclusion

Inclusion criteria:

  • ≥ 18 years of age
  • Medication refractory OAB, identified per American Urological Association guidelines

Exclusion

Exclusion criteria:

  • Post void residual urine >150ml on two occasions
  • Untreated, symptomatic UTI
  • Comorbid neurological conditions, including spinal cord injury, systemic neurologicillnesses (i.e. multiple sclerosis, Parkinson's disease) or central nervous systemdisease (i.e. brain tumor, stroke)
  • Prior pelvic irradiation
  • Current or prior bladder malignancy
  • Hematuria lacking a clinically appropriate evaluation
  • Chronic indwelling or intermittent catheterization

Study Design

Total Participants: 22
Treatment Group(s): 3
Primary Treatment: Extended Antibiotics
Phase: 4
Study Start date:
July 01, 2018
Estimated Completion Date:
June 01, 2022

Study Description

Intravesical injection of OnabotulinumtoxinA (BTX-A) is a widely practiced third line therapy for non-neurogenic overactive bladder (OAB). However, a paucity of data exists regarding urinary tract infections (UTI), the most common adverse event following injection. The investigators propose a randomized, controlled cross-over trial to investigate the utility of commonly practiced antibiotic protocols and simultaneously derive information regarding risk factors for post-procedural UTIs and their affect on treatment efficacy.

The investigators plan to initiate a prospective, randomized non-inferiority cross-over trial, in which a participant receives peri-procedural antibiotics exclusively at the time of one injection, and then at a subsequent injection, completes a three-day course of antibiotics post-operatively in addition to the peri-procedural dose. Enrollment is planned to achieve a total of 68 participants. Participants will be evaluated at 3 weeks and 3 months following injection to identify adverse events and treatment success. Inter-injection time will be measured and used a surrogate for efficacy over multiple injections.

These results, in addition to filling a void in current literature regarding the increasingly utilized treatment with BTX-A, have the potential to modify clinical practice regarding antibiotic use and decrease rates of adverse events. The means to stratify patients based on their specific risk of UTI may be used to facilitate antibiotic stewardship and improve patient outcomes.

Connect with a study center

  • Vanderbilt University Medical Center

    Nashville, Tennessee 37232
    United States

    Site Not Available

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