Abstract
Introduction: Cystoscopy is a urological procedure that, despite its minimally invasive nature, carries a risk of postoperative urinary tract infection (UTI), and preventing such infections is clinically important. Ceftriaxone, a broad‑spectrum third‑generation cephalosporin, is commonly used in surgical prophylaxis, yet its effectiveness in reducing post‑cystoscopy UTI has not been clearly established.
Objectives: This study aimed to evaluate whether a single preoperative dose of ceftriaxone reduces the incidence of postoperative UTI in patients who received ceftriaxone compared to those who did not.
Patients and Methods: This prospective case‑control study was conducted at Al‑Diwaniyha Teaching hospital in Iraq between April 2022 and April 2024, enrolling 200 patients undergoing flexible cystoscopy who were divided into two equal groups; one received a single preoperative dose of one gram of ceftriaxone, while the other had no antibiotic prophylaxis. Baseline demographic data were collected, and urine cultures were obtained within 24 hours before cystoscopy and again 5–7 days postoperatively. Outcomes assessed included postoperative urine culture results, occurrence of symptomatic UTI, and UTI requiring treatment, allowing comparison of infection rates between the ceftriaxone and control groups.
Results: The results showed that non-use of prophylactic ceftriaxone was not significantly associated with higher rates of post-operative infection outcomes. For post-operative urine culture positivity, symptomatic UTI, and UTI requiring treatment, the odds ratios were 1.51, 1.34, and 1.70 in the unadjusted model and 1.33, 1.17, and 1.49 in the adjusted model (adjusted for age and gender as a confounder), respectively; however, all analyses were non-significant (P > 0.05).
Conclusion: Omitting prophylactic ceftriaxone during flexible cystoscopy was not linked to increased post-procedural UTI, indicating that routine use may be unnecessary, requiring more judicious antibiotic therapy management.