[Prophylaxis of urinary tract infections in subjects with spinal cord injury and bladder function disorders - current clinical practice].

OBJECTIVES

The aim of this study was to investigate current clinical practice in the prevention of urinary tract infections (UTI) in persons with spinal cord injury in German-speaking spinal cord injury centres.

METHODS

A standardised questionnaire was mailed to 16 German-speaking spinal cord injury rehabilitation centres.

RESULTS

Of the 16 centres, 13 responded. The most common strategies for prevention of UTI were antibiotics, urine acidification and cranberry products, although a recent meta-analysis demonstrated that there is no evidence for the usefulness of any of these substances; on the contrary, the use of antibiotics leads to the induction of resistant bacterial strains.

CONCLUSION

Even in specialised centers, prevention of UTI in patients with spinal cord injuries is based rather on the personal experience of the treating physicians than on published evidence. This may at least partly be due to the paucity of evidence-based data. The widespread use of antibiotics carries substantial future risks. Therefore in future, evidence-based studies evaluating the success of the preventive strategies currently in use are urgently needed.