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Thomas Flaig, MD
Thomas Flaig, MD
Posted: Friday, May 5, 2023
According to Thomas Dreyer, MD, PhD, of Aarhus University Hospital, Denmark, and colleagues, patients with non–muscle-invasive bladder cancer have a high rate of recurrence, resulting in multiple flexible cystoscopies, and thus a higher risk for urinary tract infection. The investigators compared the number of patients prescribed antibiotics for urinary tract infections after flexible cystoscopies with those who underwent the Xpert® Bladder Cancer Monitor (XBCM) urinary biomarker test. The results of this randomized trial were presented during the American Urological Association (AUA) Annual Meeting 2023 (Abstract MP08-04) and published in The Journal of Urology.
“The findings of the present study support the hypothesis that replacing cystoscopy with XBCM can reduce the use of antibiotics for urinary tract infections during follow-up of non–muscle-invasive bladder cancer,” the study authors concluded. “Thus, the morbidity of follow-up of non–muscle-invasive bladder cancer with flexible cystoscopies can be reduced, resulting perhaps in less development of multiresistant uropathogenic bacteria and increased quality of life.”
This noninferiority trial focused on 392 patients with high-grade non–muscle-invasive bladder cancer who collected prescriptions for urinary tract infections. The intervention arm included patients who were followed with XBCM every 4 months and received yearly flexible or periflexible cystoscopies, and the control arm included those who were not followed with XBCM.
Approximately 23.7% and 31.0% of patients in the intervention and control arms collected a prescription, respectively. Of visits without prescheduled flexible cystoscopies, 6.3% of patients in the intervention arm collected a prescription within 14 days of the procedure versus 13.4% in the control group (P = .02). The use of antibiotics among patients undergoing periflexible cystoscopies was significantly higher in the control group (P = .03), and there was a significant reduction in the number of flexible cystoscopies performed in the intervention arm (P < .0001).
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