Recommendations for the prevention and treatment of adverse effects of intravesical BCG.

Intravesical Calmette-Guérin bacillus (BCG) instillation is the treatment of choice after transurethral resection of intermediate- and high-risk non-muscle-invasive bladder tumors (NMIBT). However, adverse effects (AEs) of BCG are common and can compromise adherence to treatment. Therefore, a group of experts in urology, hospital pharmacy and nursing reviewed the most recent literature and developed a series of practical recommendations for the prevention, early detection, and treatment of adverse events (AEs) associated with BCG vaccination. These include a questionnaire for AE detection, the treatment of the most common local and systemic AEs, and precautionary recommendations, ranging from BCG preparation to excreta management. Special attention has been given to a multidisciplinary and coordinated approach between urologists, hospital pharmacists and nurses to optimize treatment adherence.