PURPOSE: The frequency of febrile urinary tract infection was determined after outpatient flexible cystoscopy in antibiotic naïve patients with bladder tumor.
MATERIALS AND METHODS: A total of 3,108 outpatient cystoscopies were performed in 1,110 patients with bladder tumor. Immediately before cystoscopy patients submitted a voided urine sample for culture. Significant bacteriuria was defined as greater than 104 cfu/ml of a single organism. Patients received no antibiotics immediately before or after cystoscopy. They were followed for 30 days for onset of febrile urinary tract infection.
RESULTS: Of the 3,108 patient cystoscopies 673 (22%) had asymptomatic bacteriuria and 2,435 (78%) had sterile urine. A febrile urinary tract infection developed within 30 days of cystoscopy in 59 patients (1.9%), including in 3.7% of infected and 1.4% of uninfected patients (p = 0.01). All cases resolved within 12 to 24 hours with oral antibiotics. No patient was hospitalized for bacterial sepsis.
CONCLUSIONS: Antibacterial therapy before outpatient flexible cystoscopy does not appear necessary in patients who have no clinical signs or symptoms of acute urinary tract infection, including bacteriuria.
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Herr HW. Are you the author?
Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York.
Reference: J Urol. 2014 Jul 18. pii: S0022-5347(14)03963-9.
doi: 10.1016/j.juro.2014.07.015
PubMed Abstract
PMID: 25046618