This study aims to evaluate and directly compare the efficacy of a single dose of Ciprofloxacin (500 mg) with a full course of Trimethoprim (5 days) as antibiotic prophylaxis following botulinum toxin injections into the bladder wall under local anaesthesia.

A cohort of patients referred between October 2022 and April 2023 was included in the study. Follow-up assessments were conducted at 2 weeks post-procedure. Inclusion criteria comprised patients undergoing botulinum toxin injections, while exclusion criteria involved individuals with intermittent self-catheterization (ISC), long-term catheters (LTC), known hypersensitivity to Ciprofloxacin, or those with microorganisms resistant to Ciprofloxacin in prior mid-stream urine (MSU) cultures

Fifty-six patients (37 females, 19 males) were included in the study, receiving a single dose of Ciprofloxacin (500 mg) immediately post-procedure. Of these, 5 patients (3 females, 2 males) developed a urinary tract infection (UTI), representing 8.9% of the cohort. Notably, 4 of these 5 patients had previously received a 5-day course of Trimethoprim after prior botulinum toxin injections and did not experience UTIs.

In a second cohort of 40 patients (29 females, 11 males) with a history of prior botulinum toxin injections into the bladder wall, a 5-day course of Trimethoprim was administered post-procedure. Of these, 3 patients (2 females, 1 male) developed a UTI, corresponding to 7.5% of the cohort. None of these 3 patients had a UTI after receiving Ciprofloxacin post-procedure in the prior intervention.

The results suggest that both a single dose of Ciprofloxacin and a 5-day course of Trimethoprim are effective in preventing UTIs following botulinum toxin injections into the bladder wall. The incidence of UTIs observed in both groups (8.9% for Ciprofloxacin and 7.5% for Trimethoprim) was comparable, indicating that a single dose of Ciprofloxacin may be just as effective as a prolonged course of Trimethoprim. These findings imply that a single dose of Ciprofloxacin could be a viable alternative to a full course of Trimethoprim, potentially offering a more convenient and cost-effective option for antibiotic prophylaxis in this clinical setting.

A single dose of Ciprofloxacin (500 mg) administered post-procedure demonstrated comparable efficacy to a 5-day course of Trimethoprim in preventing post-procedural UTIs following botulinum toxin injections into the bladder wall under local anaesthesia. Neither regimen showed superiority or inferiority over the other in terms of UTI prevention.