Pilot study to compare the efficacy of the usual recommended prophylactic antibiotic to the addition of oral ciprofloxacin for patients undergoing radical prostatectomy

ABSTRACT

Background: This is a randomized, prospective, double-blind pilot study to compare the efficacy of preoperative cephalosporin to the addition of ciprofloxacin to avoid positive urinary culture in patients undergoing radical prostatectomy. Material and Methods: Sixty-four patients with similar clinical features and who underwent radical prostatectomy were split into three antibiotic groups group A using prophylactic preoperative cephalosporin; group B using the prophylactic cephalosporin plus one day ciprofloxacin and group C using the prophylactic cephalosporin plus ciprofloxacin for 5 days. Urine samples, taken before surgery and after removal of the indwelling catheter, were evaluated. For statistical analysis, we used Chi-square test to establish the association of the antibiotic regimen and positive urinary culture in the univariate analysis and logistic regression in the multivariate analysis. Results: Less urinary infection rate was observed in both groups receiving the addition of ciprofloxacin for one and five days (20 and 9.5 percent, respectively) compared to the use of single preoperative cephalosporin (52.1 percent; p=0.0047). Conclusions: This study suggests that the usual recommendation of preoperative cephalosporin alone may not be adequate to avoid high rates of urinary positive culture in patients undergoing radical prostatectomy.