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Randomized clinical trial on antimicrobial prophylaxis for flexible urethrocystoscopy
Antonio Jiménez-Pacheco1, Pablo Lardelli Claret, Alfonso López Luque
1Urology Department, Hospital Santa Ana, Granada, España. anjipa29@hotmail.com
Archivos Espanoles De Urologia
|June 27, 2012
Summary
This study found that a single dose of fosfomycin trometamol did not significantly reduce urinary tract infections (UTIs) after flexible urethrocystoscopy. Further research is needed to confirm these findings on antibiotic prophylaxis for UTI prevention.
Area of Science:
- Urology
- Infectious Diseases
- Clinical Trials
Background:
- Flexible urethrocystoscopy poses a risk of urinary tract infection (UTI).
- Antimicrobial prophylaxis is considered to mitigate this risk, but optimal strategies remain debated.
- This study investigated the efficacy of fosfomycin trometamol for UTI prevention post-procedure.
Purpose of the Study:
- To assess the effectiveness of a single 3-gram dose of fosfomycin trometamol in preventing UTIs after flexible urethrocystoscopy.
- To evaluate the incidence of bacteriuria, pyuria, and microhematuria in patients receiving chemoprophylaxis versus a control group.
- To provide evidence for optimizing antibiotic use in urological procedures.
Main Methods:
- A pilot randomized clinical trial involving 60 patients undergoing flexible urethrocystoscopy.
- Intervention group (30 patients) received 3g fosfomycin trometamol; control group (30 patients) received no antibiotic.
- Urine cultures, sediment analysis, and a one-month follow-up survey were conducted to assess outcomes.
Main Results:
- No statistically significant differences in bacteriuria, pyuria, or microhematuria were observed between the fosfomycin group and the control group.
- Analysis per protocol and intention to treat yielded similar non-significant results.
- The incidence rates for bacteriuria, pyuria, and microhematuria were comparable across both groups.
Conclusions:
- Antibiotic chemoprophylaxis with fosfomycin trometamol did not demonstrate a clinically relevant reduction in UTI incidence following flexible urethrocystoscopy in this selected population.
- Appropriate aseptic techniques may be sufficient for UTI prevention in this context.
- Further investigation into antibiotic prophylaxis for urological procedures is warranted.
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