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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2009 February;22(1):1-4
Oral treatment with levofloxacin in oncological urology: retrospective analysis of clinical results
Costantino G. 1, Aiello R. 2, Clementi S. 2, De Meo L. 2, Matera M. 1
1 Dipartimento di Farmacologia Sperimentale e Clinica Università di Catania, Italia
2 Humanitas-Centro Catanese di Oncologia, Catania, Italia
Aim. Herein we report our findings about the use of oral chemoprophylaxis of urinary infections in an Uro-Oncological Department. In particular, clinical data of oral for monodose levofloxacin administration to patients affected by oncologic pathologies and undergoing to different urological treatments have been collected. It is noteworth to mention that this study is retrospective and is not randomized; therefore, the results of this research are consequently independent from patient’s age and from urine pre-operative sterilization and they can give us practice indications for the future.
Methods. Four hundred forty-three patients, affected by systemic or urologic pathology and candidates to several procedures (prostatic biopsy, ureteroscopy, TURP, TURBT, urethral cystoscopies, penis amputation etc.) in which was not essential the parenteral administration of antibiotics, were treated with a single oral dose of levofloxacin, 500 mg once a day, administrated the day before the operation and for five days after. No antibiotic was given after levofloxacin and urine-culture was performed on the fourteenth post-surgery day, except for patients who had kept a catheter with or without continuous vesicle lavage; in these cases bacteriological test was also done the day after removal of the catheter.
Results. Three hundred eighty five patients have completed the treatment and a follow-up; for the remaining patients fever or intolarnce to the drugs limited the treatment. The chemoprophylaxis was efficient and complete for the majority of the patients, higher in urine-sterile subjects and in those with healthier conditions.
Conclusion. Levofloxacin per os at the monodose of 500 mg/daily is very useful during urological procedures in an oncological department and has clearly similar clinical results to parenteral administration of common antibiotics; the incidence of adverse events has been moderate. We believe that the oral levofloxacin prophylaxis may be effective in several cases of urologic operations, especially for daily-surgery and endoscopic procedures.