[Oral ofloxacin versus intramuscular ceftriaxone in antibiotic prophylaxis in transurethral prostate resection]

Abstract

This randomized prospective study evaluated the safety and efficacy of a single oral dose of OFL compared to a single parenteral dose of CTRX prior to TURP. 191 patients (mean age: 68.7 +/- 6.2 years) with bacterial free urine before surgery were enrolled and received either OFL: 400 mg per os (n = 95) or CTRX: 1 g intrasmuscularly (n = 96) at the pre-anaesthetic medication time (two hours prior TURP). Two urine cultures were obtained: on the day of the patient's discharge and within one month after surgery. Blood cultures were performed in case of temperature > 38 degrees 5C. Treatment failure was defined as bacteriuria > 10(5) CFU/ml and/or in case of positive blood culture after surgery. 182 patients were evaluable for efficacy. They were similar with respect to age, prostatic resection, histology, duration of post operative catheterization in the two treatment groups. On discharge from the department, 93.2% of the patients in the OFL group had sterile urines versus 94.6% in the CTRX group. In failure, causative pathogens were in the OFL group: 3 enterococcus, 1 acinetobacter, 1 staphylococcus, 1 citrobacter; in the CTRX group: 1 acinetobacter, 2 citrobacters, 1 enterococcus, 1 streptococcus. No bacteremia occurred. After one month of follow-up, 171 patients were evaluable (success on discharge from the department): the rates of success were: 93.5% in the OFL group and 90.3% in the CTRX group. Tolerance was good in both groups. These two drugs are as effective and as well tolerated for prevention of post operative UTI in TURP. But Ofloxacin is cost effective and simplest for use.