Conclusions : Antibiotic prophylaxis did confer a reduction in cases of symptomatic and asymptomatic bacteriuria but the NNT were high .
Introduction : The role of antibiotic prophylaxis for routine flexible cystoscopy ( FC ) is not clear due to the varying practice s of individual clinicians .
There are no formal guidelines , and this may be due to a lack of formal summary of the data .
Randomized clinical trial on antimicrobial prophylaxis for flexible urethrocystoscopy.
OBJECTIVES One of the main drawbacks of flexible urethrocystoscopy is the risk of urinary tract infection ( UTI ) . In order to reduce this risk , antimicrobial prophylaxis has been considered , however there is not a unanimous view regarding indications , dosage , type of antibiotic , and so on . To clarify this uncertainty , we practice d a pilot and experimental study aim ed at assessing the effectiveness of chemoprophylaxis with 3 grams of fosfomycin trometamol in the prevention of UTI after urethrocystoscopy . METHODS Sixty patients were entered into a pilot r and omized clinical trial between March and August 2011 . Thirty patients were assigned to a control group without receiving any antibiotic dose , and the intervention group ( 30 patients ) received 3 g fosfomycin trometamol . Ten days later urine culture and sediment analysis were performed in all patients . Significant bacteriuria was considered from > 105 CFU /ml . One month later a telephone survey was developed to assess urinary symptoms , and assistance to the family doctor . We estimated the cumulative incidence of bacteriuria , pyuria and microhematuria in both groups , and we compared the results using a strategy of analysis per protocol and intention to treat . RESULTS The incidence of bacteriuria , pyuria and microhematuria in the control group was 10 % , 23.3 % and 26.7 % respectively and in the intervention groups the values differed depending on the type of analysis . Considering only the 27 patients ( per protocol analysis ) , the incidence would be 11.1 % , 37.0 % and 29.6 % respectively . If we include the three patients who did not completed the study ( per intention to treat analysis ) and considering their results as negative , the results were 10 % , 33.3 % and 26.7 % respectively . Finally , in the case the three cultures not performed in this group had produced a positive result , the impact would have been 20.0 % , 43.3 % and 36.7 % . In any of the three cases , the differences with the control group were not statistically significant . CONCLUSIONS In a selected population and with appropriate aseptic measures , antibiotic chemoprophylaxis does not appear to show a clinical ly relevant reduction in the incidence of UTI in patients undergoing flexible urethrocystoscopy
Conclusions : Antibiotic prophylaxis did confer a reduction in cases of symptomatic and asymptomatic bacteriuria but the NNT were high .
Introduction : The role of antibiotic prophylaxis for routine flexible cystoscopy ( FC ) is not clear due to the varying practice s of individual clinicians .
There are no formal guidelines , and this may be due to a lack of formal summary of the data .