Hirakauva Elizabeth Yukie, Bianchi-Ferraro Ana Maria Homem de Mello, Zucchi Eliana Viana Monteiro, Kajikawa Marcio Massashi, Girão Manoel João Batista Castello, Sartori Marair Gracio Ferreira, Jarmy-Di Bella Zsuzsanna Ilona Katalin de
Department of Gynecology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ginecol Obstet. 2017 Oct;39(10):534-540. doi: 10.1055/s-0037-1604066. Epub 2017 Jun 30.
The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study. Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS. We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria. We didn't observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group. The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.
尿液中存在细菌被称为菌尿症，菌尿症可能有症状，也可能无症状。尿动力学检查（UDS）是一种侵入性操作，在此过程中对尿路的操作可能会导致尿路感染（UTI）。关于在尿动力学检查中使用预防性抗生素的研究结果相互矛盾。一些研究者得出结论认为它们是有价值的，而另一些人则不这么认为。本研究的目的是评估尿动力学检查前抗生素预防的效果。这是一项安慰剂对照的随机双盲研究。217名受尿失禁影响的女性符合本研究条件。所有患者在尿动力学检查前尿培养均为阴性。她们被随机分为四组：A组接受安慰剂，B组接受500毫克左氧氟沙星，C组接受80毫克甲氧苄啶和400毫克磺胺甲恶唑，D组接受100毫克呋喃妥因。尿动力学检查14天后进行尿培养。我们观察到，尿动力学检查后，A组有5名患者、B组有1名患者、C组有1名患者和D组有1名患者出现无症状菌尿症。只有A组的1名患者出现有症状菌尿症。我们未观察到各组之间存在统计学差异。当我们将患者重新分为两组时，安慰剂组的菌尿症发生率显著高于抗生素组。结论是，尿动力学检查前的抗生素预防并未降低目标人群中女性尿路感染的发生率。
