Postoperative prophylaxis with norfloxacin in patients requiring bladder catheters

The effect of once daily doses of 200 mg oral norfloxacin on the occurrence of catheter-associated bacteriuria (greater than 1000 CFU/ml) and pyuria was studied in 105 post-operative gynaecologic patients. Norfloxacin was given from the second day after surgery until catheter removal. Bacteriuria developed in 32 of 51 (63%) control patients compared to 8 of 54 (15%) patients receiving norfloxacin (p less than 0.001). Pyuria was present in 22 of 51 (43%) control subjects versus only 3 of 54 (5%) patients treated with norfloxacin (p less than 0.001). Bacteria isolated from control patients comprised species of Enterobacteriaceae (40%), Staphylococcus (35%), and Streptococcus (17%); seven isolates were resistant to multiple antibiotics reflecting their nosocomial origin. In contrast, strains isolated from norfloxacin-treated patients comprised non-fermenting gram-negative rods (79%, usually Alcaligenes or Acinetobacter spp.) and faecal streptococci (12%). It is concluded that once daily doses of 200 mg oral norfloxacin are effective in reducing the rate of catheter-associated bacteriuria and pyuria following reconstructive gynaecologic surgery.