They studied 192 patients with lower urinary tract symptoms who had sterile urine prior to UDS. They were randomized to be given either ciprofloxacin 500mg one hour prior to their UDS or no antibiotic. In this study a urinary tract infection was defined as ? 100,000 colony forming units per milliliter.

Pre UDS, 19% of patients had taken some antibiotic in the preceding month for various reasons and18% had pyuria without significant bacteruria. 98 patients (47 female and 51 male) received antibiotic prophylaxis while 94 patients (44 female and 50 male) were in the control group. Post UDS, a total of 14 patients (7.3%) developed significant bacteruria (1% of the antibiotic groups and 14% of the control groups). There was no relationship between patient sex and the development of bacteruria. Those who had pyuria prior to UDS and those who had taken antibiotics within the last month were more likely to develop significant bacteruria after UDS. No patients receiving ciprofloxacin reported any side effects.

The authors concluded that the use of ciprofloxacin 500 mg one hour prior to UDS results in a significant decrease in post procedure UTI when compared to taking no antibiotics. Three independent risk factors associated with significant bacteruria after UDS were no antibiotic prophylaxis prior to study, the presence of pyuria before the study, and the use of an antibiotic in the preceding month before UDS. As the treatment was well tolerated by all, the authors do recommend antibiotic prophylaxis in all patients undergoing UDS to prevent post UDS urinary tract infections.

Urology 2006; 67: 1149-1153

Written by M. Louis Moy, MD, a Contributing Editor with UroToday.

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