Ap. Christiano et al., Double-blind randomized comparison of single-dose ciprofloxacin versus intravenous cefazolin in patients undergoing outpatient endourologic surgery, UROLOGY, 55(2), 2000, pp. 182-185
Objectives. To compare the efficacy of single-dose oral ciprofloxacin with
intravenous cefazolin as a prophylactic agent in patients undergoing outpat
ient endourologic surgery.
Methods. One hundred patients were enrolled in a double-blind, randomized s
tudy to receive either ciprofloxacin (500 mg) or cefazolin (1 g) before sur
gery. A postoperative clinical evaluation and urine cultures were performed
5 to 10 days after surgery. Patients undergoing ureteral stent insertion o
r exchange, ureteroscopy, bladder biopsy, retrograde pyelography, collagen
injection, and internal urethrotomy were included.
Results. Postoperative urinary tract infection occurred in 7 (9.1%) of 77 p
atients, including 3 (8.1%) of 57 and 4 (10.0%) of 40 of those who received
ciprofloxacin and cefazolin, respectively (P = 0.77). There were no episod
es of sepsis, and no patient with infection required hospitalization. The t
otal cost associated with the administration of prophylactic antibiotics in
the study population was $3657 less in those 50 patients who received cipr
ofloxacin than in the 50 patients who received cefazolin.
Conclusions. A single oral dose of ciprofloxacin in patients undergoing out
patient endourologic surgery was equally effective as cefazolin in preventi
ng postoperative urinary tract infection, but was associated with markedly
lower overall costs. (C) 2000, Elsevier Science Inc.