Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy

BJU Int. 2007 Oct;100(4):826-9. doi: 10.1111/j.1464-410X.2007.07093.x.

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 >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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Anti-Infective Agents, Urinary / therapeutic use*
  • Antibiotic Prophylaxis*
  • Bacteriuria / prevention & control*
  • Ciprofloxacin / therapeutic use*
  • Cystoscopy / adverse effects*
  • Double-Blind Method
  • Humans
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome
  • Trimethoprim / therapeutic use*

Substances

  • Anti-Infective Agents, Urinary
  • Ciprofloxacin
  • Trimethoprim