Does SUFU's best practice policy statement regarding antibiotic prophylaxis predict urinary tract infection after urodynamic study? : Evidence from a retrospective cohort.

Purpose: To validate the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Best Practice Policy Statement (BPPS) risk factors (RFs) for predicting urinary-tract infection (UTI) after urodynamic study (UDS) and to identify possible RFs that could better guide antibiotic prophylaxis.

Methods: A retrospective cohort study included all adults undergoing UDS at a single institution. Patients with asymptomatic bacteriuria received a 3-day antibiotic course, while those without bacteriuria received no prophylaxis. The primary endpoint was a culture-confirmed UTI within 7 days. Regression analysis was performed to check SUFU BPPS RFs as predictors for post-UDS UTI.

Results: Among 1666 patients (median age 68 years; 42% female), UTI occurred in 31 (1.9%). Abnormal GU anatomy was found as a predictor for post-UDS UTI (OR = 3.26, p = 0.033). Other examined RFs were not found to predict post-UDS UTI. More concise variables were identified as statistically significant predictors: hydronephrosis (OR = 4.98, p = 0.004), elevated post-void residual (PVR) (OR = 2.80, p = 0.011), and NLUTD due to neurologic disease (OR = 2.27, p = 0.042). In multivariate analysis, elevated PVR and NLUTD caused by neurologic disease remained independent predictors.

Conclusion: The current SUFU BPPS criteria exhibit limited accuracy for predicting post-UDS UTI. Our study emphasizes hydronephrosis, NLUTD caused by neurologic disease, and elevated PVR as predictors of post-UDS UTI. Updating prophylactic guidelines to incorporate these findings could enhance patient safety and antimicrobial stewardship without compromising infection control.