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[Antimicrobial prophylaxis in urethrocystoscopy. Comparative study]

J F Jiménez Cruz1, S Sanz Chinesta, G Otero

  • 1Servicio de Urología, Hospital La Fe, Valencia.

Actas Urologicas Espanolas
|March 1, 1993
PubMed
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Urinary tract instrumentation can cause infections. Antimicrobial prophylaxis significantly reduced symptomatic bacteriuria after urethrocystoscopy in a large randomized study.

Area of Science:

  • Urology
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Lower urinary tract instrumentation is a known risk factor for urinary tract infections (UTIs).
  • Urethrocystoscopy is a common urological procedure that can lead to infective complications.
  • Evaluating preventative strategies is crucial for patient safety in urological procedures.

Purpose of the Study:

  • To assess the incidence of infective complications following urethrocystoscopy.
  • To determine the efficacy of antimicrobial prophylaxis in preventing post-instrumentation UTIs.
  • To compare outcomes between patients receiving prophylaxis and a control group.

Main Methods:

  • A multicenter, prospective, comparative, and randomized study involving 2,284 patients with negative baseline urine cultures.

Related Experiment Videos

  • Patients were randomized to receive either standard care (control) or antimicrobial prophylaxis (ceftriaxone 1g IM) before urethrocystoscopy.
  • Clinical and microbiological responses were monitored at 48-72 hours and 4 weeks post-procedure.

    • Main Results:

    • Symptomatic bacteriuria occurred in 10.2% of the control group versus 2.5% in the prophylaxis group (p < 0.000).
    • Asymptomatic bacteriuria rates were 3.02% (control) and 1.52% (prophylaxis) (p > 0.05).
    • Irritative syndrome with sterile urine showed no significant difference between groups (2.93% vs. 2.60%, p > 0.05).

    Conclusions:

    • Antimicrobial prophylaxis with ceftriaxone significantly reduces the incidence of symptomatic bacteriuria after urethrocystoscopy.
    • Prophylaxis appears effective in preventing overt infectious complications in patients undergoing lower urinary tract instrumentation.
    • The findings support the routine use of antimicrobial prophylaxis to mitigate UTI risk in this patient population.