BERKELEY, CA (UroToday.com) - While cystoscopy is a widely utilized procedure for urologic patients, complications may arise which can increase costs to the health system, the resistance of microorganisms, and contribute to morbidity in patients.
The clinical trial outlined in our article excluded patients who had any allergy to antibiotics, were taking other medication which could interact with the study drugs or for the purpose of prophylaxis for other health conditions (e.g., prosthetic heart valve, heart murmur, prosthetic orthopedic or vascular), were taking antibiotics at the time of the procedure, or who had a history of a permanent urethral catheter. We also excluded patients with immunosuppression, spinal cord injury requiring intermittent catheterization, or who required a urethral catheter after the study procedure.
This study is pertinent and relevant because of the following:
- No positive urine culture was found before the procedure, this allows having patients with sterile urine before, and it will make the patients and their results comparable.
- UTI is the primary outcome and was considered according to literature (symptoms and urine culture).
- No other procedures were accepted; it was just for cystoscopy.
Related to the statistical power of the clinical trial, another important topic is that the ‘‘no differences’’ could have been due to the absolute rate of UTI, which was lower than expected in a calculated sample size, and this could be considered as a limitation. Not considering a specific time for those urine cultures, before the procedure, was found as a weakness, but in this study, it was accepted up to 1 month from the date of the result to perform the procedure. No specific time was found in literature, and this could be another related issue, as it is very widely accepted from 10 to 30 days.
The conclusion of this article is clear: There are no differences. However, according to the literature, just two articles are really methodologically good, but yet the results are different. That is why as a part of my doctoral thesis (University of Granada – PhD in clinical medicine and Public Health), a systematic review of the literature/meta-analysis will be performed to address the real answer to the question: Is it effective to administer prophylactic antibiotic previous to cystoscopy in patients with a negative urine culture? I´ll let you know the results.
Written by:
Herney Andrés García-Perdomo, MD, MSc, PhDc as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
University of Valle, Cra 35 No 3a-38 Ap 301, Cali, Colombia
Efficacy of antibiotic prophylaxis in patients undergoing cystoscopy: A randomized clinical trial - Abstract
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