Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy
Article first published online: 15 AUG 2007
Volume 100, Issue 4, pages 826–829, October 2007
How to Cite
Johnson, M. I., Merrilees, D., Robson, W. A., Lennon, T., Masters, J., Orr, K. E., Matthews, J. N.S. and Neal, D. E. (2007), Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy. BJU International, 100: 826–829. doi: 10.1111/j.1464-410X.2007.07093.x
- Issue published online: 15 AUG 2007
- Article first published online: 15 AUG 2007
- Accepted for publication 27 April 2007
- urinary infection;
- flexible cystoscopy;
- randomised controlled trial;
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.
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.
This large trial shows clearly that one dose of oral ciprofloxacin significantly reduces bacteriuria after FC.