膀胱镜检前预防性应用抗生素的多中心临床研究

Multi-center clinical trial of antibiotic prophylaxis for patients before cystoscopy

目的：探讨膀胱镜检查前预防性应用抗生素的临床价值。方法：采用多中心前瞻性临床研究的方法，选取2012年9月～2013年10月中段尿标本培养阴性的患者357例，随机分为两组。A组177例，为预防性应用抗生素组，检查前30～60分钟口服左氧氟沙星500mg；B组180例，为对照组，检查前30～60分钟口服安慰剂。比较膀胱镜检查后两组患者尿路感染的发生率。结果：A组患者尿路感染发生率为1．1％；B组患者尿路感染发生率为3．9％，两组比较差异无统计学意义（P=0．096）。结论：无高危因素存在时，预防性应用抗生素并不能降低膀胱镜检查后尿路感染的发生率。

Objective：To investigate the clinical values of antibiotic prophylaxis for patients before cystoscopy. Method： A prospective multi-center clinical trial was taken in 357 patients whose results of mid-stream urine cul- ture were negative from September 2012 to October 2013. The enrolled patients were randomly divided into two groups including group A （177 cases） who received oral antibiotic prophylaxis with a single 500 mg dose of levo- floxacin 30-60 minutes before cystoscopy and group B （180 cases） who were given placebo 30--60 minutes before cystoscopy. The statistical analysis was performed using a Chi-Square test in order to evaluate the differences be- tween two groups in the incidence of urinary tract infection （UTI）. Result：The incidence of UTI in group A was 1.1% while 3.9% was in group B. No statistically significant difference （P=0. 096） was shown between these two groups. Conclusion： Administration of antibiotics before cystoscopy is not the key to preventing the occurrence of UTI if there is no risk factors.