Is antibiotic prophylaxis required for flexible cystoscopy? A truncated randomized double-blind controlled trial.

Abstract:

PURPOSE:To examine the incidence of urinary tract infection (UTI) after flexible cystoscopy (FC) and determine whether prophylactic norfloxacin reduces this incidence compared with placebo. PATIENTS AND METHODS:A double-blind trial was performed, randomizing 234 patients to either 400 mg of norfloxacin or placebo prior to FC. All patients provided a midstream urine specimen (MSU) before the procedure, as well as at day 3 and day 7 after FC. In addition, a telephone questionnaire was performed to correlate the nature and severity of any symptoms associated with UTI. RESULTS:Interim analysis was performed because of the low recruitment rate, and a significantly lower infection rate than expected meant that the trial was discontinued. There was one symptomatic UTI in the placebo group (0.82%) and one in the norfloxacin group (0.89%). The UTI in the placebo group was de novo, while the infection in the norfloxacin group was secondary to pre-FC bacteriuria. There was no difference in the infection rates in the two groups. The overall infection rate (de novo and secondary to existing bacteruria) after FC was 0.85%. CONCLUSION:Infection after flexible cystoscopy is rare and not associated with significant morbidity. A much larger study would be required to determine whether antibiotic prophylaxis significantly reduces the rate of postprocedure UTI.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Wilson L,Ryan J,Thelning C,Masters J,Tuckey J

doi

10.1089/end.2005.19.1006

subject

Has Abstract

pub_date

2005-10-01 00:00:00

pages

1006-8

issue

8

eissn

0892-7790

issn

1557-900X

journal_volume

19

pub_type

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