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

Area of Science:

• Urology
• Infectious Diseases
• Clinical Trials

Background:

• Urinary tract infections (UTIs) can be a complication following urological procedures.
• Flexible cystoscopy (FC) is a common diagnostic procedure.

Purpose of the Study:

• To determine the incidence of UTI after flexible cystoscopy (FC).
• To evaluate the efficacy of prophylactic norfloxacin in preventing post-FC UTIs compared to placebo.

Main Methods:

• A double-blind, placebo-controlled trial involving 234 patients undergoing FC.
• Patients received either 400 mg norfloxacin or placebo before the procedure.
• Urine specimens and symptom questionnaires were collected pre-procedure and at 3 and 7 days post-procedure.

Main Results:

• The study was discontinued early due to low recruitment and lower-than-expected infection rates.
• One symptomatic UTI occurred in the placebo group (0.82%) and one in the norfloxacin group (0.89%).
• No significant difference in UTI rates was observed between the norfloxacin and placebo groups (overall rate 0.85%).

Conclusions:

• Infection following flexible cystoscopy is infrequent and generally has low morbidity.
• A larger study is necessary to definitively assess the benefit of antibiotic prophylaxis for post-procedure UTIs.