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.
RCT Entities:
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: Steeve Doizi; Guido Kamphuis; Guido Giusti; J L Palmero; J M Patterson; Silvia Proietti; Michael Straub; Jean de la Rosette; Olivier Traxer Journal: World J Urol Date: 2016-12-17 Impact factor: 4.226
Authors: Magnus Grabe; Henry Botto; Mete Cek; Peter Tenke; Florian M E Wagenlehner; Kurt G Naber; Truls E Bjerklund Johansen Journal: World J Urol Date: 2011-07-22 Impact factor: 4.226
Authors: Christian Daniel Fankhauser; Sharon Waisbrod; Cindy Fierz; Anton S Becker; Benedikt Kranzbühler; Daniel Eberli; Tullio Sulser; Hugh Mostafid; Thomas Hermanns Journal: World J Urol Date: 2020-04-02 Impact factor: 4.226
Authors: Justin R Gregg; Caroline L Kang; Thomas R Talbot; Derek Moore; S Duke Herrell; Roger Dmochowski; Daniel A Barocas Journal: Urol Pract Date: 2016-10-22