DRI_2020/03

Treatment tested

• Levofloxacin anhydrous
• Sulfamethoxazole

  Bacterial dihydropteroate synthase inhibitor

• Amdinocillin pivoxil

  Bacterial penicillin-binding protein 2 inhibitor

• Aztreonam

  Bacterial penicillin-binding protein inhibitor

• Cefixime

  Bacterial penicillin-binding protein inhibitor

• Nitrofurantoin

  DNA inhibitor

• Trimethoprim

  Bacterial dihydrofolate reductase inhibitor

• Ciprofloxacin

  Bacterial DNA gyrase inhibitor|Topoisomerase IV inhibitor

• Amoxicillin

  Bacterial penicillin-binding protein inhibitor

• Ceftriaxone
• Fosfomycin
• Ofloxacin

  Bacterial DNA gyrase inhibitor

• Lidocaine

  Sodium channel alpha subunit blocker

Other measures (15)

Inclusion: - Female and male over 18 years-old - Multiple Sclerosis or Spinal Cord Injury (traumatic or non-traumatic) - Clean Intermittent Self-Catheterization as the exclusive bladder management - Refractory Detrusor Overactivity leading to urinary incontinence (failure, intolerance or contra-indication to anti-muscarinic therapy) - Treated with intra-vesical BoNTA injections having proved efficacy - Asymptomatic Bacteriuria (bacteriuria threshold ≥ 10² CFU/mL) on pre-operative urine analysis (performed 5 days (+/- 2 days) before intra-vesical BoNTA injections) - With a personal and functional e-mail address, a quasi-permanent Internet connection and a mobile phone. Exclusion: - Contra-Indication to botulinum toxin a, and excipients included in study drugs - Ongoing cyclic antibiotic therapy - Ongoing corticosteroid therapy - Modification of immunosuppressive or immunomodulatory therapy in the 3 months before inclusion - Antibiotic therapy in the month before inclusion - Absence of use of any recognized contraceptive method (e.g. hormonal, barrier, IUD, sterilization) or of consistent sexual abstinence - Individuals especially in need of protection - No informed consent - Patients incapable to follow the trial, e.g. because of language problems, psychiatric disorders, dementia and so on. - Immunocompromised patients - Patient without easy access to internet within 6 weeks of the injection - Surgical procedure in the 3 months before and the 6 weeks following inclusion - Symptomatic UTI at the time of inclusion - Associated neurologic disease - • Pregnancy or breast feeding - Having already participated to the study - Augmentation cystoplasty - Bladder compliance disorders (<20 mL/cmH2O) - Morphologic urinary tract abnormalities considered as a risk factor for recurrent symptomatic UTI

To demonstrate the non-inferiority of “antibiotic sparing strategy” compared to “peri-operative antibiotic strategy” (current recommendations) for occurrence of symptomatic UTI after intra-vesical BoNTA injection in the management of asymptomatic bacteriuria (AB) among MS and SCI patients undergoing CISC.