Quinolones News

#18 May 2, 2017

Prophylactic levofloxacin reduces incidence of urinary tract infection following post-urodynamic study

Antibiotic prophylaxis given prior to invasive urological procedures such as urodynamic studies (UDS) is an accepted therapeutic strategy, but requires careful use to avoid the development of antibiotic resistance. Fluoroquinolones possess good activity against major UTI pathogens, but until now no study has assessed the benefit of prescribing levofloxacin post-UDS. Researchers performed a randomized double-blind clinical trial comparing levofloxacin 500 mg once a day for 3 days after UDS versus nontreated patients. Clinical efficacy was based on the incidence of lower UTI, defined as one or more clinical symptoms (dysuria, frequency, urgency or suprapubic pain) and one or more urinalysis parameters (leucocyturia, positive for bacteria, nitrite, and leucocyte esterase).  

126 adult patients who underwent UDS in two urological clinics in Jakarta were enrolled. All had standard catheterisation prior to UDS and after UDS each patient was assigned to either three days of levofloxacin tablets 500 mg once daily or placebo tablets once daily.
63 patients received levofloxacin and 63 received placebo. Lower UTI was confirmed in 26 cases out of 126 patients post-UDS (20.6%), with 8 patients from the levofloxacin treated group (12.7%) and 18 from the placebo arm (28.6%); p = 0.028). E. coli was the most common bacteria identified (n=18 patients; 69.2%) followed by K. pneumoniae, Enterococcus spp and Bacillus spp.

Researchers noted that the incidence of UTI post UDS was quite high in this study (20.6%) and that using levofloxacin post-UDS significantly reduced the incidence of infection (12.7% vs. 28.6%; p=0.028), providing  an effective and useful prophylactic therapy.

PMID: 27550876

Acta Med Indones. 2016 Apr;48(2):84-90.

Source: https://www.ncbi.nlm.nih.go v/pubmed/27550876?dopt=Abstract

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