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Antibiotikaprofylax vid kirurgiska ingrepp - SBU

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Table 4.12.3 Cystoscopy.<br />

Author<br />

Year<br />

Reference<br />

Country<br />

Study<br />

design<br />

Population<br />

characteristics<br />

Intervention<br />

Method<br />

Number indi<strong>vid</strong>uals<br />

Control<br />

Number<br />

indi<strong>vid</strong>uals<br />

Results<br />

Withdrawal<br />

Drop outs<br />

Study quality<br />

and relevance<br />

Comments<br />

Jimenez Cruz<br />

1993<br />

[9]<br />

Spain<br />

RCT<br />

Cystoscopy<br />

Follow-up<br />

2–3 days<br />

and 1 month<br />

I: Single dose 1 g cefriaxone<br />

im (n=1 115)<br />

C: No ab<br />

(n=1 057)<br />

ABU<br />

I: 1.5%<br />

C: 3%<br />

Symptomatic UTI<br />

I: 2.5%<br />

C: 10.2%<br />

3.3% High<br />

Significant reduction<br />

of BU/UTI from<br />

10.2 to 2.5%. Fewer<br />

severe infections in<br />

ABP group<br />

Pyelonephritis/epididymitis/prostatitis<br />

I: 1/3/1 pts<br />

C: 11/5/0 pts<br />

Johnson<br />

2007<br />

[8]<br />

United<br />

Kingdom<br />

RCT<br />

FC<br />

Follow-up<br />

5 days<br />

I1: Single dose<br />

trimetoprim<br />

200 mg (n=690)<br />

I2: Single dose<br />

ciprofoxacin 500 mg<br />

po (n=653)<br />

C: Placebo<br />

(n=658)<br />

BU<br />

I1: 22/690 (3.2%)<br />

I2: 13/653 (2%)<br />

C: 45/658 (6.8%)<br />

I1 vs C: OR 0.29 (95% CI 0.17–0.48)<br />

I2 vs C: p100 000 cfu/mL<br />

I: 2/67 (3%)<br />

C: 3/59 (5%)<br />

Overall BU after FC=4%.<br />

No significant reduction of BU<br />

Not reported<br />

Moderate<br />

No rational for ABP<br />

in FC<br />

No difference men and women<br />

MacDermott<br />

1988<br />

[11]<br />

United<br />

Kingdom<br />

RCT<br />

Cystoscopy.<br />

No BU<br />

I: 3 doses 1 g cephradine<br />

within 24 h (n=47)<br />

C: No ab (n=51) BU/UTI >100 000 cfu/mL<br />

I: 1/47 (2.1%)<br />

C: 8/51 (15.7%)<br />

Significant reduction of BU/UTI<br />

from 15.7 to 2.1%<br />

11% High<br />

E coli most freqvent<br />

general anesthesia<br />

Manson<br />

1988<br />

[12]<br />

USA<br />

RCT<br />

Cystoscopy<br />

No BU<br />

before<br />

Follow-up<br />

2 weeks<br />

I: 3 days po TMP/SMZ,<br />

nitrofurantoin or a<br />

cephalosporine (n=84)<br />

C: No ab (n=84) BU/UTI >100 000 cfu/mL<br />

I: 1/66 (1.5%)<br />

C: 2/72 (2.8%)<br />

ns<br />

18% Moderate<br />

Large drop out<br />

The table continues on the next page<br />

450 antibiotikaprofylax <strong>vid</strong> <strong>kirurgiska</strong> <strong>ingrepp</strong> KAPITEL 4 • den systematiska litteraturöversikten<br />

451

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