Effectiveness of antibiotic prophylaxis in preventing bacteriuria after multichannel urodynamic investigations: a blind, randomized study in 124 female patients. Is antibiotic prophylaxis necessary for routine urodynamic investigations? A controlled study in 100 patients. [Early antibiotic therapy following urodynamic examination. Results of a randomized, controlled study]. Effectiveness of ciprofloxacin prophylaxis in preventing bacteriuria caused by urodynamic study: a blind, randomized study of 192 patients. Antibiotic prophylaxis for urodynamic testing in patients with spinal cord injury: a preliminary study. The usefulness of antibiotic prophylaxis in invasive urodynamics in postmenopausal female subjects. Antibiotic treatment to prevent urinary tract infections after urodynamic evaluation. Antibiotic prophylaxis after instrumentation for urodynamic testing.
One hundred twenty-four women with chronic, persistent lower urinary tract symptoms who had been scheduled for elective urodynamic investigations at Mount Sinai's Urodynamic Investigative Unit were divided into two blind, randomized groups, receiving either a placebo or prophylactic antibiotic. At the time of urodynamic testing, the rate of unsuspected urinary tract infection was 8.1%. There was no statistically significant decrease in postinstrumentation infection rate in the group who received prophylactic antibiotics. We conclude that, given in the fashion described in the study, prophylactic antibiotics are not effective in preventing urinary tract infections caused by urodynamic testing. The value of a prophylactic antibiotic before a routine cystometrogram has been assessed in a controlled trial of 100 patients. The infection rate was low and not statistically different in both groups. Subsequent symptoms of dysuria and haematuria had a mechanical aetiology. Forty-three young men from the Italian army underwent urodynamic tests following the diagnosis of enuresis. Of these, 37 were included in an assessment trial to define the rationale for early anti-bacterial therapy following the test. The subjects were subdivided into two groups: one group received 500 mg Cinoxacin b.i.d. for 5 days, and the other group was not treated. The comparison of results revealed a high incidence of irritative disorders in both groups (78.9% of treated subjects and 88.9% of untreated subjects) but the most significant complications were observed in the untreated group (feveret in 27.7% and one case of septic fever). Early anti-bacterial therapy following standard urodynamic tests therefore seems to be a ration tool in urological practice. 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. This study was performed in order to: (i) determine the incidence of symptomatic urinary tract infection (UTI) in patients with spinal cord injury after urodynamic testing; (ii) evaluate the role of antibiotic prophylaxis for such a procedure; and (iii) investigate whether pre-existing bacteriuria predisposes to the development of symptomatic UTI after urodynamic testing. Forty patients were prospectively randomized in a double-blind fashion to receive a 3-day oral course of either ciprofloxacin (18 patients) or placebo (22 patients), beginning 2 days prior to the urodynamic procedure. None of 18 (0%) patients who received ciprofloxacin developed symptomatic UTI within 5 days after the procedure compared with three of 22 (14%) subjects randomized to the placebo group; the protective efficacy of antibiotic prophylaxis, however, did not attain statistical significance (P = 0.24). None of the three bacterial isolates that were responsible for symptomatic infection were grown in corresponding urine cultures prior to the procedure. These findings may serve as a pilot for a larger study. This study aims to define the usefulness of antibiotic prophylaxis of urinary tract infection (UTI) in postmenopausal female undergoing invasive urodynamics (IU). Two hundred sixty-two postmenopausal females underwent IU. Before urodynamics, all females were double blindly randomized in two age stratified groups. Group 1 (130 patients) received oral antibiotic prophylaxis with a single 400-mg dose of norfloxacin. Group 2 (132 patients) received norfloxacin placebo. Statistical analysis was performed by a chi (2) test to evaluate differences between groups for UTI incidence rate. Fifty-four patients of 262 (20.6%) resulted affected by UTI [24 of 130 subjects who received antibiotic prophylaxis (18.4%) and 30 of 132 subjects who received placebo (22.7%)]. There was no statically significant difference (P = 0.242) regarding UTI incidence rate between patients who received and those who did not received antibiotic prophylaxis. UTI incidence rate in postmenopausal women undergoing urodynamics is not affected by administration of antibiotic prophylaxis at the desired level of efficacy. The aim of the study was to determine the efficacy of cotrimoxazole administration after urodynamic testing to prevent urinary tract infections. In a single-blind prospective randomized study 94 women who attended for urodynamic evaluation were included. After multichannel urodynamic testing, including two catheterizations, the women received a single dose of cotrimoxazole or placebo. A clean-catch urine specimen was tested for infection after 1 week. Seventy women returned a urine specimen after 1 week: 2/37 (5.4%) in the treatment and 2/33 (6.1%) in the placebo group had acquired a new urinary tract infection after urodynamics. One major and one minor adverse reaction to cotrimoxazole were reported. The power of the sample size was unfortunately too small to draw conclusions as to the efficacy of prophylaxis. This study of 96 women shows that there is doubtful value in routine antibiotic prophylaxis after urodynamic investigation. An unexpectedly high number of women harboured unsuspected infections at the time of evaluation despite prior screening, which suggests prophylaxis would be more useful if given before the tests.
Prophylactic antibiotics did reduce the risk of bacteriuria after urodynamic studies but there was not enough evidence to suggest that this effect reduced symptomatic urinary tract infections. There was no statistically significant difference in the risk of fever, dysuria or adverse reactions. Potential benefits have to be weighed against clinical and financial implications, and the risk of adverse effects.