Prophylactic Antibiotics for Urinary Tract Infections after Urodynamic Studies: A Meta-Analysis

Abstract

Aim. We aimed to perform a meta-analysis to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infections (UTIs) after urodynamic studies (UDS). Methods. We conducted a systematic search of PubMed, Web of Science, Ovid, Elsevier, ClinicalKey, Embase, Cochrane Library, Medline, and Wiley Online Library. Randomized controlled trials (RCTs) comparing the effectiveness of prophylactic antibiotics with placebo or no treatment in preventing UTI after UDS were included. Two reviewers extracted data independently, and RevMan 5.3 software was used to analyze relative risk (RR) with 95% confidence intervals (CI). Heterogeneity was assessed by the $Q$ test and $I^2$ test. Results. The final meta-analysis included 1829 patients in 13 RCTs. Compared with the placebo or no treatment group, prophylactic antibiotics could significantly reduce the risk of bacteriuria ( $\text{RR}=0.42$ , 95% CI: 0.30-0.60) and the risk of symptomatic UTI ( $\text{RR}=0.65$ , 95% CI: 0.48-0.88). In addition, there was no statistically significant difference in the risk of adverse events ( $\text{RR}=4.93$ , 95% CI: 0.61-40.05). No significant heterogeneity or publication bias was found in this study. Conclusions. Current evidence showed that prophylactic antibiotics could reduce the risk of asymptomatic bacteriuria and symptomatic UTI after UDS without increasing the incidence of adverse events.