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Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy

Lookup NU author(s): Dr Mark Johnson, Teresa Lennon, Dr Katherine Orr, Professor John Matthews, Professor David Neal

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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 >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.


Publication metadata

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

Year: 2007

Volume: 100

Issue: 4

Pages: 826-829

Print publication date: 01/10/2007

ISSN (print): 1464-4096

ISSN (electronic): 1464-410X

Publisher: Wiley-Blackwell Publishing Ltd.

URL: http://dx.doi.org/10.1111/j.1464-410X.2007.07093.x

DOI: 10.1111/j.1464-410X.2007.07093.x

PubMed id: 17822463


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