LOMEFLOXACIN PROPHYLAXIS IN VISUAL LASER-ABLATION OF THE PROSTATE

Objectives. Visual laser ablation of the prostate (VLAP) is a relative ly new option for relief of urinary outlet obstruction secondary to be nign prostatic hyperplasia. There is currently no consensus regarding the optimum use of antibiotic prophylaxis in VLAP. This study was desi gned to evaluate two dosage regimens of a new difluoroquinolone, lomef loxacin, for prevention of postoperative bacteriuria following VLAP. M ethods. Sixty men with benign prostatic hyperplasia who were scheduled for VLAP were enrolled in an open-label, randomized trial comparing g roups receiving no anti-microbial prophylaxis (n = 20), a single preop erative oral dose of 400 mg lomefloxacin (n = 20), or a single preoper ative oral dose of 400 mg lomefloxacin followed by 400 mg daily for 3 days (n = 20). The VLAP procedures were performed using 60 watts of en ergy from a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser delivered via a Bard Urolase fiber or Laser Sonic fiber. Results. Ten of 20 pat ients (50%) in the no prophylaxis group developed bacteriuria (defined as growth of 10(4) or more colony-forming units/mL) during the 14 day s following surgery, whereas 2 of 20 patients (10%) in the single-dose group and 1 of 20 in the multiple-dose group (5%) developed bacteriur ia during the follow-up period. Both dosage regimens were well tolerat ed. Conclusions. Lomefloxacin was successful in preventing postoperati ve bacteriuria in 90% (single dose) to 95% (multiple doses) of patient s undergoing VLAP. There was no clinically significant difference betw een the two dosage regimens.