Skip to main content
Top
Published in: World Journal of Urology 6/2013

01-12-2013 | Original Article

Efficacy of antibiotic prophylaxis in patients undergoing cystoscopy: a randomized clinical trial

Authors: Herney Andrés García-Perdomo, Hugo López, Jorge Carbonell, Diego Castillo, Juan Guillermo Cataño, Pamela Serón

Published in: World Journal of Urology | Issue 6/2013

Login to get access

Abstract

Objective

To establish the efficacy of antibiotic prophylaxis prior to cystoscopy in outpatients in decreasing the incidence of post-procedure urinary tract infection.

Study design and setting

A randomized clinical trial in patients (men and women) older than 18 who underwent cystoscopy for any non-urgent indication. The intervention was Levofloxacin 500 mg single dose, and the control was placebo 500 mg single dose made with similar characteristics. The primary outcome was urinary tract infection (UTI) measured 3–10 days after the procedure. It was performed as per protocol analysis.

Results

Hundred and thirty-eight patients in each study arm completed the trial. The incidence of UTI in the intervention group was 0.7 % and in the placebo group was 3 % (p = 0.17), and no significant differences were found. The incidence of asymptomatic bacteriuria in the intervention group was 5.8 % and in the control group was 14.5 % (p = 0.01).

Conclusions

No significant differences were found in the use of prophylactic antibiotic compared to placebo to reduce the incidence of UTI in patients who undergo cystoscopy as an outpatient procedure with sterile urine demonstrated by urine culture.
Literature
1.
go back to reference Clark K, Higgs J (1990) Urinary infections following outpatient flexible cystoscope. BJU 66:503–505PubMedCrossRef Clark K, Higgs J (1990) Urinary infections following outpatient flexible cystoscope. BJU 66:503–505PubMedCrossRef
2.
go back to reference Almallah YZ, Rennie CD, Stone J et al (2000) Urinary tract infection and patient satisfaction after flexible cystoscope and urodynamic evaluation. Urology 56:37–39PubMedCrossRef Almallah YZ, Rennie CD, Stone J et al (2000) Urinary tract infection and patient satisfaction after flexible cystoscope and urodynamic evaluation. Urology 56:37–39PubMedCrossRef
3.
go back to reference Burke DM, Shackley D, O’reilly P (2002) The community based morbidity of flexible cystoscope. BJU Int 89:347–349PubMedCrossRef Burke DM, Shackley D, O’reilly P (2002) The community based morbidity of flexible cystoscope. BJU Int 89:347–349PubMedCrossRef
4.
go back to reference Stuart Wolf J, Bennett C, Dmochowsky R et al (2008) Best practice policy statement on urologic surgery antimicrobial profilaxis. J Urol 179:1379–1390PubMedCrossRef Stuart Wolf J, Bennett C, Dmochowsky R et al (2008) Best practice policy statement on urologic surgery antimicrobial profilaxis. J Urol 179:1379–1390PubMedCrossRef
5.
go back to reference DasGupta R, Sullivan R, French G et al (2009) Evidence based prescription of antibiotics in urology: 5 year review of microbiology. BJU Int 104:760–764PubMedCrossRef DasGupta R, Sullivan R, French G et al (2009) Evidence based prescription of antibiotics in urology: 5 year review of microbiology. BJU Int 104:760–764PubMedCrossRef
6.
go back to reference Caicedo PS, Martinez T, Meneses E (2009) Etiología y resistencia bacteriana en infección de vías urinarias en el hospital universitario de san jose de popayan Colombia entre enero y diciembre de 2008. Urol Colomb 18(3):45–52 Caicedo PS, Martinez T, Meneses E (2009) Etiología y resistencia bacteriana en infección de vías urinarias en el hospital universitario de san jose de popayan Colombia entre enero y diciembre de 2008. Urol Colomb 18(3):45–52
7.
go back to reference Bootsma AM, Laguna MP, Geerlings SE et al (2008) Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol 54:1270–1286PubMedCrossRef Bootsma AM, Laguna MP, Geerlings SE et al (2008) Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol 54:1270–1286PubMedCrossRef
8.
go back to reference Grabe M, Bishop MC, Bjerklund-Johansen TE. et al (2010). Guidelines on urological infections. EAU 81–89 Grabe M, Bishop MC, Bjerklund-Johansen TE. et al (2010). Guidelines on urological infections. EAU 81–89
9.
go back to reference Naber K, Hofstetter A, Bruhl P et al (2001) Working group ‘Urinary tract infections et al. Guidelines for the perioperative prophylaxis in urological interventions of the urinary and male genital tract. Int J Antimicrobial Agents 17:321–326CrossRef Naber K, Hofstetter A, Bruhl P et al (2001) Working group ‘Urinary tract infections et al. Guidelines for the perioperative prophylaxis in urological interventions of the urinary and male genital tract. Int J Antimicrobial Agents 17:321–326CrossRef
10.
go back to reference Christiano AP, Hollowell CM, Kim H et al (2000) Double-blind randomized comparison of singledose ciprofloxacin versus intravenous cefazolin in patients undergoing outpatient endourologic surgery. Urology 55:182–185PubMedCrossRef Christiano AP, Hollowell CM, Kim H et al (2000) Double-blind randomized comparison of singledose ciprofloxacin versus intravenous cefazolin in patients undergoing outpatient endourologic surgery. Urology 55:182–185PubMedCrossRef
11.
go back to reference Jimenez Cruz JF, Sanz Chinesta S, Otero G et al (1993) Antimicrobial prophylaxis in urethrocystoscopy. Comparative study. Actas Urol Esp 17:172–175PubMed Jimenez Cruz JF, Sanz Chinesta S, Otero G et al (1993) Antimicrobial prophylaxis in urethrocystoscopy. Comparative study. Actas Urol Esp 17:172–175PubMed
12.
go back to reference Johnson MI, Merrilees D, Robson WAL et al (2007) Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy. BJU Int 100:826–829PubMedCrossRef Johnson MI, Merrilees D, Robson WAL et al (2007) Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy. BJU Int 100:826–829PubMedCrossRef
13.
go back to reference Tsugawa M, Monden K, Nasu Y et al (1998) Prospective randomized comparative study of antibiotic prophylaxis in urethrocystoscopy and urethrocystography. Int J Urol 5:441–443PubMedCrossRef Tsugawa M, Monden K, Nasu Y et al (1998) Prospective randomized comparative study of antibiotic prophylaxis in urethrocystoscopy and urethrocystography. Int J Urol 5:441–443PubMedCrossRef
14.
go back to reference Rane A, Cahill D, Saleemi A et al (2001) The issue of prophylactic antibiotics prior to flexible cystoscopy. Eur Urol 39:212–214PubMedCrossRef Rane A, Cahill D, Saleemi A et al (2001) The issue of prophylactic antibiotics prior to flexible cystoscopy. Eur Urol 39:212–214PubMedCrossRef
15.
go back to reference Cam K, Kayikci A, Erol A (2009) Prospective evaluation of the efficacy of antibiotic prophylaxis before cystoscopy. Indian J Urol 25:203–206PubMedCrossRef Cam K, Kayikci A, Erol A (2009) Prospective evaluation of the efficacy of antibiotic prophylaxis before cystoscopy. Indian J Urol 25:203–206PubMedCrossRef
16.
go back to reference Wilson L, Ryan J, Thelning C et al (2005) Is antibiotic prophilaxis required for flexible cystoscopy? A truncated randomized double-blind controlled trial. J Endourol 19(8):1006–1008PubMedCrossRef Wilson L, Ryan J, Thelning C et al (2005) Is antibiotic prophilaxis required for flexible cystoscopy? A truncated randomized double-blind controlled trial. J Endourol 19(8):1006–1008PubMedCrossRef
17.
Metadata
Title
Efficacy of antibiotic prophylaxis in patients undergoing cystoscopy: a randomized clinical trial
Authors
Herney Andrés García-Perdomo
Hugo López
Jorge Carbonell
Diego Castillo
Juan Guillermo Cataño
Pamela Serón
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 6/2013
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-013-1034-2

Other articles of this Issue 6/2013

World Journal of Urology 6/2013 Go to the issue