Lookup NU author(s): Dr Mark Johnson,
Dr Katherine Orr,
Professor John Matthews,
Professor David Neal
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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 >105 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. © 2007 The Authors.
Author(s): Johnson MI, Merrilees D, Robson WA, Lennon T, Masters J, Orr KE, Matthews JNS, Neal DE
Publication type: Article
Publication status: Published
Journal: BJU International
Print publication date: 01/10/2007
ISSN (print): 1464-4096
ISSN (electronic): 1464-410X
Publisher: Wiley-Blackwell Publishing Ltd.
PubMed id: 17822463
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