Kartal Elif Doyuk, Yenilmez Aydin, Kiremitci Abdurrahman, Meric Hatice, Kale Metin, Usluer Gaye
Department of Clinical Bacteriology and Infectious Diseases, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey.
Urology. 2006 Jun;67(6):1149-53. doi: 10.1016/j.urology.2006.01.005.
To determine the efficacy of prophylactic ciprofloxacin in preventing urinary tract infections caused by urodynamic study (UDS).
A total of 210 patients presenting for UDS during a 16-month period were offered enrollment in the study. A clean-catch midstream urine sample was taken 24 hours before and 48 to 72 hours after the procedure and after microscopic examination and culture were done. All patients underwent a standard UDS. The 192 patients who had sterile urine before intervention were included in the study. Randomly, 98 of the 192 patients were orally given 500 mg of ciprofloxacin 1 hour before the urodynamic intervention and 94 were not given anything. The patients who were found to have significant bacteriuria after UDS were followed up and treated properly.
Eighteen patients (8.6%) who had significant bacteriuria in the urine culture before UDS were excluded from the study. The rate of significant bacteriuria in the urine culture after UDS was 7.3% overall, 1% in the prophylaxis group, and 14% in the controls, a significant difference (P = 0.002). The most common uropathogen was Escherichia coli (57%). Three independent risk factors were identified: not giving antibiotic prophylaxis before UDS; antibiotic use in the preceding month; and the presence of pyuria before UDS.
Urinary tract infections after UDS decreased from 14% to 1% with a single dose of ciprofloxacin 500 mg orally before UDS. We recommend antibiotic prophylaxis for patients undergoing a UDS.
确定预防性使用环丙沙星在预防尿动力学研究（UDS）所致尿路感染中的疗效。
在16个月期间，共有210例因UDS前来就诊的患者被纳入该研究。在操作前24小时以及操作后48至72小时采集清洁中段尿样本，进行显微镜检查和培养。所有患者均接受标准的尿动力学检查。将干预前尿液无菌的192例患者纳入研究。随机将这192例患者中的98例在尿动力学干预前1小时口服500毫克环丙沙星，94例未给予任何药物。对尿动力学检查后发现有显著菌尿的患者进行随访并适当治疗。
18例（8.6%）在尿动力学检查前尿培养中有显著菌尿的患者被排除在研究之外。尿动力学检查后尿培养中显著菌尿的总体发生率为7.3%，预防组为1%，对照组为14%，差异有统计学意义（P = 0.002）。最常见的尿路病原体是大肠杆菌（57%）。确定了三个独立的危险因素：尿动力学检查前未给予抗生素预防；前一个月使用过抗生素；尿动力学检查前存在脓尿。
尿动力学检查前口服一剂500毫克环丙沙星后，尿动力学检查后尿路感染的发生率从14%降至1%。我们建议对接受尿动力学检查的患者进行抗生素预防治疗。
