| Abstract | OBJECTIVE: To report a large prospective, pragmatic, double-blind randomized controlled trial to determine whether oral prophylactic antibiotics reduce the risk of bacteriuria after flexible cystoscopy (FC), as up to 10% of patients develop urinary infection afterwards, with significant morbidity and costs for health services. PATIENTS AND METHODS: In all, 2481 patients were recruited into a three-arm placebo controlled trial and 2083 completed it. Patients were randomly assigned to one of three treatments; (i) placebo; (ii) one oral dose of trimethoprim (200 mg); or (iii) one oral dose of ciprofloxacin (500 mg), each administered 1 h before a FC under local anaesthetic. A mid-stream urine specimen was taken before and 5 days after FC; significant bacteriuria was defined as a pure growth of >10(5) colony-forming units/mL. RESULTS: The rate of bacteriuria after FC was reduced from 9% in the placebo group to 5% and 3% in patients receiving trimethoprim and ciprofloxacin prophylaxis, respectively. When rates of bacteriuria before FC were considered the odds of developing bacteriuria after FC relative to baseline were 5, 2 and 0.5 for placebo, trimethoprim and ciprofloxacin, respectively. CONCLUSION: This large trial shows clearly that one dose of oral ciprofloxacin significantly reduces bacteriuria after FC. |
| Authors | Mark I Johnson, David Merrilees, Wendy A Robson, Teresea Lennon, John Masters, Kathy E Orr, John N S Matthews, David E Neal
(Affiliation: Freeman Hospital, Newcastle upon Tyne, UK.)
|
| Journal | BJU international
(BJU Int)
Vol. 100
Issue 4
Pg. 826-9
(Oct 2007)
ISSN: 1464-4096 England |
| PMID | 17822463
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Anti-Infective Agents, Urinary
- Trimethoprim
- Ciprofloxacin
|
| Topics |
- Administration, Oral
- Adult
- Anti-Infective Agents, Urinary
(therapeutic use)
- Antibiotic Prophylaxis
- Bacteriuria
(prevention & control)
- Ciprofloxacin
(therapeutic use)
- Cystoscopy
(adverse effects)
- Double-Blind Method
- Humans
- Prospective Studies
- Risk Factors
- Treatment Outcome
- Trimethoprim
(therapeutic use)
|
