Lowder Jerry L, Burrows Lara J, Howden Nancy L S, Weber Anne M
Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2007 Feb;18(2):159-64. doi: 10.1007/s00192-006-0121-y. Epub 2006 May 4.
The objective of this paper is to compare the risks and benefits of antibiotics to prevent urinary tract infection (UTI) after urodynamics. We developed a decision analytic model to compare the use of prophylactic antibiotics with no antibiotic use after urodynamics to prevent UTI. Risks and benefits were estimated from the literature and by consensus. The main outcome measure was the occurrence of UTI. Secondary outcomes were the development of adverse events and possible sequelae. One-way sensitivity analyses estimated the effect of varying each characteristic through its range while all other characteristics were fixed at their baseline values. The effectiveness of prophylaxis after urodynamics was a reduction of UTI from 9.2 (no antibiotics) to 5.3% (antibiotics). One-way sensitivity analysis of the probability of UTI without prophylaxis yielded a threshold infection rate of 10%, below which, the strategy of no prophylaxis was favored. In this model, prophylactic antibiotics after urodynamics are not beneficial until the rate of UTI without antibiotics exceeds 10%.
本文的目的是比较抗生素在预防尿动力学检查后尿路感染（UTI）方面的风险和益处。我们建立了一个决策分析模型，以比较在尿动力学检查后使用预防性抗生素与不使用抗生素预防UTI的情况。风险和益处是根据文献并通过共识估计得出的。主要结局指标是UTI的发生情况。次要结局是不良事件的发生和可能的后遗症。单向敏感性分析估计了在所有其他特征固定在其基线值的情况下，通过其范围改变每个特征的影响。尿动力学检查后预防的有效性是将UTI的发生率从9.2%（不使用抗生素）降低到5.3%（使用抗生素）。对未进行预防时UTI发生概率的单向敏感性分析得出阈值感染率为10%，低于该值时，不进行预防的策略更受青睐。在该模型中，直到不使用抗生素时UTI的发生率超过10%，尿动力学检查后使用预防性抗生素才有益处。
