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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 February;164(1):43-6
The antibacterial chemoprophylaxis in ureteroscopy: the employment of the levofloxacin used as switch-therapy versus oral treatment with a single 500 mg once a day
Costantino G. 1, Condorelli S. 2, Costanzo V. 2, Granata M. 2, Pisciotta F. 2, Matera M. 1
1 Section of Nephrology and Urology, Department of Pharmacology, Catania University, Catania, Italy;
2 Section of Urology, Foundation G. B. Morgagni, Catania, Italy
Aim. We have carried out a study for clinical evaluation of effectiveness and tolerance of oral monodose of levofloxacin administration within the activity of diagnostic and therapeutic ureteroscopy in a Department of Urology.
Methods. Three hundred eighty-eight patients affected by ureteral stones and candidates to ureterolithotripsy have been randomly enlisted from january 1999 to june 2002; they have been admitted to the study on the base of specific criteria: the age (more 18 years old), urine sterilization, at least verbal assent, ect. Levofloxacin has been given per os at the dose of 500 mg, once a day, 4 hours before and 5 days after the endoscopy (group A) or intravenous once only 4 hours before the treatment followed by oral administration for 5 days (group B). None antibiotic was given after levofloxacin and urine-culture was performed after the first and the second week from the operation.
Results. Three hundred fifty-six patients have completed the treatments and a correct follow-up. In the group A, we have registered 12 cases of urosepsis (6.5%), while this percentage was 7.5 % in the group B. Positive urinocoltures were present in 26 patients of the 1st group (14.1%) and in 29 of the 2nd (16.2%).
Conclusion. Levofloxacin per os at the monodose of 500 mg/die is useful during ureterosco-py and has similar clinical results of the oral/parenteral association. The incidence of adverse events has been moderate. We believe that the use of oral levofloxacin may be effective in selected cases of ureterolithotripsy, is of easy administration and useful to reduce the costs of patient’s hospitalization.