From the Research
Yes, certain IV antibiotics can cause acute urinary retention as a side effect, and healthcare providers should be aware of this potential complication, particularly in patients with pre-existing conditions like benign prostatic hyperplasia or neurological disorders. The mechanism of this adverse effect involves anticholinergic properties, neuromuscular blockade, and potential inflammation of the prostate in men. Key points to consider include:
- Antibiotics most commonly associated with acute urinary retention include aminoglycosides, fluoroquinolones, and some beta-lactams 1.
- Patients at higher risk include those with pre-existing conditions like benign prostatic hyperplasia, neurological disorders, or those taking other medications with anticholinergic effects 2.
- Management involves switching to an alternative antibiotic class, implementing bladder drainage with catheterization if necessary, and addressing any underlying risk factors 3.
- The urinary retention typically resolves after discontinuation of the causative antibiotic, though it may take several days for normal bladder function to return.
In terms of specific management strategies, the use of alpha-blockers has been shown to improve the success rate of trial without catheter (TWOC) in patients with acute urinary retention 4, 3. Additionally, suprapubic catheterization may be a useful alternative to urethral catheterization in some cases 3. Overall, a comprehensive approach to managing acute urinary retention involves careful consideration of the underlying cause, patient risk factors, and individualized treatment strategies to minimize morbidity and mortality, and improve quality of life 2, 3.