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Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy
Author(s) -
Johnson Mark I.,
Merrilees David,
Robson Wendy A.,
Len Teresea,
Masters John,
Orr Kathy E.,
Matthews John N.S.,
Neal David E.
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07093.x
Subject(s) - bacteriuria , medicine , trimethoprim , placebo , ciprofloxacin , cystoscopy , urinary system , sulfamethoxazole , odds ratio , antibiotics , urine , urology , surgery , gastroenterology , microbiology and biotechnology , pathology , biology , alternative medicine
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.