title: Oral ciprofloxacin or trimethoprim reduces bacteriuria after flexible cystoscopy.
abstract: OBJECTIVE
  To report a large prospective, pragmatic, double-blind randomized controlled trial to determine whether oral prophylactic antibiotics reduce the risk of bacteriuria after flexible cystoscopy (FC), as up to 10% of patients develop urinary infection afterwards, with significant morbidity and costs for health services.
  
  
  METHODS
  In all, 2481 patients were recruited into a three-arm placebo controlled trial and 2083 completed it. Patients were randomly assigned to one of three treatments; (i) placebo; (ii) one oral dose of trimethoprim (200 mg); or (iii) one oral dose of ciprofloxacin (500 mg), each administered 1 h before a FC under local anaesthetic. A mid-stream urine specimen was taken before and 5 days after FC; significant bacteriuria was defined as a pure growth of >10(5) colony-forming units/mL.
  
  
  RESULTS
  The rate of bacteriuria after FC was reduced from 9% in the placebo group to 5% and 3% in patients receiving trimethoprim and ciprofloxacin prophylaxis, respectively. When rates of bacteriuria before FC were considered the odds of developing bacteriuria after FC relative to baseline were 5, 2 and 0.5 for placebo, trimethoprim and ciprofloxacin, respectively.
  
  
  CONCLUSIONS
  This large trial shows clearly that one dose of oral ciprofloxacin significantly reduces bacteriuria after FC.
authors.affiliation: Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Johnson
authors.forename: David
authors.initials: D
authors.lastname: Merrilees
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Robson
authors.forename: Teresea
authors.initials: T
authors.lastname: Lennon
authors.forename: John
authors.initials: J
authors.lastname: Masters
authors.forename: Kathy E
authors.initials: KE
authors.lastname: Orr
authors.forename: John N S
authors.initials: JN
authors.lastname: Matthews
authors.forename: David E
authors.initials: DE
authors.lastname: Neal
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001437:Bacteriuria / Q000517:prevention & control*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003558:Cystoscopy / Q000009:adverse effects*; D004311:Double-Blind Method; D006801:Humans; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014295:Trimethoprim / Q000627:therapeutic use*