Lomefloxacin prophylaxis in visual laser ablation of the prostate

Visual laser ablation of the prostate (VLAP) is a relatively new option for relief of urinary outlet obstruction secondary to benign prostatic hyperplasia. There is currently no consensus regarding the optimum use of antibiotic prophylaxis in VLAP. This study was designed to evaluate two dosage regimens of a new difluoroquinolone, lomefloxacin, for prevention of postoperative bacteriuria following VLAP.

Sixty men with benign prostatic hyperplasia who were scheduled for VLAP were enrolled in an open-label, randomized trial comparing groups receiving no antimicrobial prophylaxis (n = 20), a single preoperative oral dose of 400 mg lomefloxacin (n = 20), or a single preoperative oral dose of 400 mg lomefloxacin followed by 400 mg daily for 3 days (n = 20). The VLAP procedures were performed using 60 watts of energy from a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser delivered via a Bard Urolase fiber or Laser Sonic fiber.

Ten of 20 patients (50%) in the no prophylaxis group developed bacteriuria (defined as growth of 10(4) or more colony-forming units/mL) during the 14 days following surgery, whereas 2 of 20 patients (10%) in the single-dose group and 1 of 20 in the multiple-dose group (5%) developed bacteriuria during the follow-up period. Both dosage regimens were well tolerated.

Lomefloxacin was successful in preventing postoperative bacteriuria in 90% (single dose) to 95% (multiple doses) of patients undergoing VLAP. There was no clinically significant difference between the two dosage regimens.