Stefan den Hoedt, Felice E.E. van Veen, Jeroen R. Scheepe, Bertil F.M. Blok
{"title":"用自来水冲洗膀胱，减少导尿管使用者尿路感染的抗生素用量","authors":"Stefan den Hoedt, Felice E.E. van Veen, Jeroen R. Scheepe, Bertil F.M. Blok","doi":"10.1111/bju.16552","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To evaluate the safety and effectiveness of bladder irrigation (BI) with tap water to reduce antibiotic use for the treatment of urinary tract infections (UTIs) in patients with recurrent UTI symptoms and to assess the treatment satisfaction of BI.</p>\n </section>\n \n <section>\n \n <h3> Patients and Methods</h3>\n \n <p>This prospective, observational study included patients with an indwelling catheter or performing clean intermittent catheterisation (CIC) who had recurrent UTI symptoms between July 2022 and March 2024. BI with tap water was used for the treatment of UTIs without systemic symptoms (e.g., fever, flank pain or delirium). Patients started daily irrigation at the onset of UTI symptoms and used a tapering schedule. The number of antibiotic treatments for UTIs, UTI incidence rate ratio (IRR), UTI-related hospitalisations, treatment satisfaction and quality of life (QoL) were compared between a 3-month period before and after BI with tap water.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 60 patients were included with a median (interquartile range) age of 64.5 (50.4–72.6) years, 66.7% were male, and 83.3% were performing CIC. Antibiotic use was decreased on average by 38.1% (IRR = 0.62; <i>P</i> = 0.016) and catheter-associated UTIs by 37.9% (IRR = 0.62; <i>P</i> = 0.005). No increase was observed in the incidence of UTIs with systemic symptoms or UTI-related hospitalisations. In addition, no differences were observed in the health-related QoL. The majority of patients were positive about the subjective effectiveness (81%), ease of use (86%) and overall satisfaction (85%) of BI with tap water.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>These findings emphasise the potential of BI with tap water as a promising and patient-friendly alternative for the treatment of UTIs in patients with urinary catheters. BI with tap water significantly reduces antibiotic use and UTI incidence in patients with recurrent UTIs and is a safe and patient-friendly alternative that can be easily implemented in the management of UTIs.</p>\n </section>\n </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 2","pages":"286-294"},"PeriodicalIF":3.7000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16552","citationCount":"0","resultStr":"{\"title\":\"Bladder irrigation with tap water to reduce antibiotic use for urinary tract infections in catheter users\",\"authors\":\"Stefan den Hoedt, Felice E.E. van Veen, Jeroen R. Scheepe, Bertil F.M. Blok\",\"doi\":\"10.1111/bju.16552\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To evaluate the safety and effectiveness of bladder irrigation (BI) with tap water to reduce antibiotic use for the treatment of urinary tract infections (UTIs) in patients with recurrent UTI symptoms and to assess the treatment satisfaction of BI.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Patients and Methods</h3>\\n \\n <p>This prospective, observational study included patients with an indwelling catheter or performing clean intermittent catheterisation (CIC) who had recurrent UTI symptoms between July 2022 and March 2024. BI with tap water was used for the treatment of UTIs without systemic symptoms (e.g., fever, flank pain or delirium). Patients started daily irrigation at the onset of UTI symptoms and used a tapering schedule. The number of antibiotic treatments for UTIs, UTI incidence rate ratio (IRR), UTI-related hospitalisations, treatment satisfaction and quality of life (QoL) were compared between a 3-month period before and after BI with tap water.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 60 patients were included with a median (interquartile range) age of 64.5 (50.4–72.6) years, 66.7% were male, and 83.3% were performing CIC. Antibiotic use was decreased on average by 38.1% (IRR = 0.62; <i>P</i> = 0.016) and catheter-associated UTIs by 37.9% (IRR = 0.62; <i>P</i> = 0.005). No increase was observed in the incidence of UTIs with systemic symptoms or UTI-related hospitalisations. In addition, no differences were observed in the health-related QoL. The majority of patients were positive about the subjective effectiveness (81%), ease of use (86%) and overall satisfaction (85%) of BI with tap water.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>These findings emphasise the potential of BI with tap water as a promising and patient-friendly alternative for the treatment of UTIs in patients with urinary catheters. BI with tap water significantly reduces antibiotic use and UTI incidence in patients with recurrent UTIs and is a safe and patient-friendly alternative that can be easily implemented in the management of UTIs.</p>\\n </section>\\n </div>\",\"PeriodicalId\":8985,\"journal\":{\"name\":\"BJU International\",\"volume\":\"135 2\",\"pages\":\"286-294\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-10-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16552\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJU International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/bju.16552\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJU International","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/bju.16552","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估用自来水进行膀胱冲洗（BI）以减少抗生素使用的安全性和有效性，从而治疗反复出现尿路感染（UTI）症状的患者，并评估 BI 的治疗满意度。
Bladder irrigation with tap water to reduce antibiotic use for urinary tract infections in catheter users
Objective
To evaluate the safety and effectiveness of bladder irrigation (BI) with tap water to reduce antibiotic use for the treatment of urinary tract infections (UTIs) in patients with recurrent UTI symptoms and to assess the treatment satisfaction of BI.
Patients and Methods
This prospective, observational study included patients with an indwelling catheter or performing clean intermittent catheterisation (CIC) who had recurrent UTI symptoms between July 2022 and March 2024. BI with tap water was used for the treatment of UTIs without systemic symptoms (e.g., fever, flank pain or delirium). Patients started daily irrigation at the onset of UTI symptoms and used a tapering schedule. The number of antibiotic treatments for UTIs, UTI incidence rate ratio (IRR), UTI-related hospitalisations, treatment satisfaction and quality of life (QoL) were compared between a 3-month period before and after BI with tap water.
Results
A total of 60 patients were included with a median (interquartile range) age of 64.5 (50.4–72.6) years, 66.7% were male, and 83.3% were performing CIC. Antibiotic use was decreased on average by 38.1% (IRR = 0.62; P = 0.016) and catheter-associated UTIs by 37.9% (IRR = 0.62; P = 0.005). No increase was observed in the incidence of UTIs with systemic symptoms or UTI-related hospitalisations. In addition, no differences were observed in the health-related QoL. The majority of patients were positive about the subjective effectiveness (81%), ease of use (86%) and overall satisfaction (85%) of BI with tap water.
Conclusion
These findings emphasise the potential of BI with tap water as a promising and patient-friendly alternative for the treatment of UTIs in patients with urinary catheters. BI with tap water significantly reduces antibiotic use and UTI incidence in patients with recurrent UTIs and is a safe and patient-friendly alternative that can be easily implemented in the management of UTIs.
期刊介绍：
BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
