Eur Urol Suppl 2011;10(2):163 Materials & Methods: From January 2009 to July 2010, 115 consecutive patients were enrolled in this randomized multi-centre trial. Inclusion criteria were female gender, age over 18 years, no allergies or counter-indications to the drugs to be prescribed, urine culture responsiveness to drugs at patient recruitment, history of UTI with at least three episodes in the previous year or two in the past six months. Exclusion criteria were pregnancy and lack of tolerability of prescribed drugs. Patients with recurrent UTI who were referred to our outpatient clinics, were prospectively randomised by a computer generated sequence to Pruliloxacin (1 tablet/week for 12 weeks – group A) and Phosphomycin (1 cachet/week for 12 weeks – group B). Follow-up: Check-ups were scheduled at the following time- points: 2 weeks, 1 and 3 months from the beginning of the study and 3, 6, and 12 months after suspension of therapy. Primary outcome was negative urine culture. X 2 , Friedman and Mann-Whitney tests were applied for data analysis. results: 86/115 (74.78%) patients with a minimum follow-up of 12 months were included in this analysis: 41 patients in group A and 45 in group B. During follow- up 7/41 patients (group A) and 4/45 (group B) were lost. Table 1 summarizes the study results. The frequency of UTIs was reduced signiicantly (p<0.0001) in patients who received 3-months antibiotic prophylaxis. When the Pruliloxacin and Phosphomycin prophylactic schedules were compared no signiicant differences were found in eficacy i.e. reduction of the number of urinary tract infection episodes during and after prophylaxis, in adverse effects or in speciic drug resistance after therapy. TAB.1 Group A Group B Total Patients achieving 12 month follow-up 41 45 86 Lost at follow-up 7 4 11 UTI-free patients during prophylaxis 22/38 (58%) 25/42(60%) 47/80(59%) UTI-free patients 3 months after end of prophylaxis 13/37 ( 35%) 20/42 (48%) 33/79 (42%) UTI-free patients 6 months after end of prophylaxis 13/37 (35%) 18/42 (43%) 31/79 (40%) UTI-free patients 12 months after end of prophylaxis 9/34 (27%) 13/41 (32%) 22/75 (30%) Adverse events 4/38* (10.5%) 2/42** (4.8%) 6/80 (7.5%) Drug resistance 5/38 ( 13%) 2/42 (4.8%) 6/80 (7.5%) Conclusions: We found that both drugs provided an adequate prophylactic regimen in patients with recurrent UTI. The patient satisfaction with both of them was very high, but no difference in eficacy was recorded between them. 481 effiCaCy and safety of CiProfloxaCin xr 1000 Mg onCe daily versus CiProfloxaCin 500 Mg twiCe daily in the treatMent of CoMPliCated urinary traCt infeCtions Verze P., Fusco F., Imbimbo C., Palmieri A., Mangiapia F., Creta M., Taglialatela D., Chiancone F., Mirone V. University of Naples - 'Federico II', Dept. of Urology, Naples, Italy introduction & objectives: The aim of this trial was to compare the eficacy and safety of extended-release ciproloxacin (CIPRO XR) versus the immediate- release formulation (CIPRO IR) in the treatment of complicated urinary tract infections (UTIs). Materials & Methods: 212 patients with complicated UTIs were randomized to CIPRO XR 1,000 mg tablet once daily or CIPROXIN IR 500 mg tablet twice daily for a period of 7-14 days according to their clinical status and response to treatment. The primary diagnosis of the patients included in the study was cUTI, deined as: 1) UTI with one or more clinical symptoms and signs of lower UTI; fever, chills, frequency of micturition, dysuria, urge sensation; 2) the presence of one or more of the following underlying conditions: indwelling urinary catheter; 100 ml of residual urine after voiding; neurogenic bladder; obstructive uropathy due to lithiasis, tumor or ibrosis; acute urinary retention in men. Treatment eficacy was evaluated by bacteriological outcome. Safety was measured by recording adverse events. results: The rate of bacteriological eradication was 83% in the CIPRO XR group and 75% in the CIPRO IR. The clinical and bacteriological response rates were similar in the different stratiied gender and age groups. However, there was a trend to lower bacteriological and clinical response rates for subjects over 65 compared with subjects under 65 years of age in both treatment groups. The stratiied analysis of clinical response according to bacteriological success gave a high correspondence between clinical cure and bacteriological success, being about 83% in the CIPRO XR group and 86% in the CIPRO IR group. The incidence of treatment-emergent events reported during the study was low, with somewhat higher incidence rates in the CIPRO IR group (6% vs 4%). The most common adverse events were gastrointestinal disorders and renal and urinary disorders. Conclusions: We can conclude that CIPRO XR is a safe and effective treatment for complicated UTIs. Although the limited data available do not consent to support a statistically superior eficacy or safety compared to CIPRO IR, a trend in favor of CIPRO XR is clearly evident in all eficacy and safety variables. CIPRO XR is associated with reduced frequencies of drug-related adverse events compared to CIPRO IR. 482 in vitro aCtivity of daPtoMyCin and PrulifloxaCin against Multi-drugs resistant staPhyloCoCCus and enteroCoCCus sPP. isolated froM reCurrent urinary traCt infeCtion Patients Mazzoli S. 1 , Cai T. 2 , Meacci F. 1 , Malossini G. 2 , Bartoletti R. 3 1 Santa Maria Annunziata Hospital, Sexually Transmitted Diseases Centre, Florence, Italy, 2 Santa Chiara Hospital, Dept. of Urology, Trento, Italy, 3 University of Florence, Dept. of Urology, Florence, Italy introduction & objectives: Multi-drugs resistant Gram positives strains are, today, the more frequently isolated bacteria from recurrent urinary tract infection (UTI) patients. The aim of the present study was to investigate the in vitro activities of Daptomycin and Pruliloxacin against Enterococci and Staphylococci wild strains in patients with recurrent UTI. Materials & Methods: 97 multi-resistant strains, 77 strains of Enterococcus faecalis and 20 strains of Staphylococcus spp. were isolated from urinary biological samples collected from outpatients affected by recurrent UTI. Two ATCC (American type cell culture) strains of Enterococcus faecalis (ATCC 29212, 51299) and two of Staphylococcus aureus (ATCC 29213, 25923) were used as reference strains. VITEK II BioMèrieux automatic system (BioMèrieux, Italy) was used for strains identiication test and antibiotic sensitivity test. The strain identiication was also conirmed by API 20 Strep and ID 32 Staph (BioMèrieux, Italy). Moreover, a microbial culture using CBA (Columbia Blod Agar) dishes was setup to obtain pure coltures for the antibiotic susceptibility test (Kirby-Bauer method) and to perform Etest, in order to test susceptibility to Pruliloxacin and Daptomycin, respectively. results: All Staphylococcus spp. and E. faecalis strains examined resulted sensitive to daptomycin with a MIC between 0,25 µg/ml and 1,00 µg/ml and between 0,125 µg/ml and for 4 µg/ml, respectively. 93% of E. faecalis strains resulted sensitive to pruliloxacin and 45% of Staphylococcus spp. too. Conclusions: Both Daptomycin and Pruliloxacin showed excellent in vitro activity in our population of multi-resistant Enterococcus spp. and Staphylococcus spp. demonstrating a good performance proile. 483 the effeCtiveness of aCoustiC energy induCed by uroshield deviCe in the Prevention of baCteriuria and the reduCtion of Patients’ CoMPlaints related to long-terM indwelling urinary Catheters Nagy K., Köves B., Tenke P. Jahn Ferenc South-Pest Hospital, Dept. of Urology, Budapest, Hungary introduction & objectives: Due to the long-term urinary catheter the development of bacteriuria and bioilm formation is inevitable. This can lead to symptomatic urinary tract infections. Microbiological and clinical studies related to short term catheterization demonstrated, that applying devices attached to catheters which release low-energy surface acoustic waves prevent bioilm formation and reduce bacteriuria caused by catheter usage and decrease catheter-related complaints (pain, tenesmus). The aim of the recent prospective study is to measure the effectiveness of the UroShield device in the prevention of catheter-associated bacteriuria and in the reduction of catheter-related complaints in patients requiring long-term urinary catheterization. Materials & Methods: The device, which was used in the recent study, consists of a piezo element that is placed onto the external portion of the catheter and a driver unit to which the piezo element connects. Between August 2009 and September 2010 a total of 27 patients were recruited for the study in which 14 patients received a UroShield device for 8 weeks. The control group consisted of 13 patients that received urinary catheters without UroShield devices. At the time of catheter insertion and after every two weeks urine culture was taken and health condition was checked, furthermore the patients’ catheter-related complaints were documented on a numerical scale of 1 to 10. More than 10x5 CFU/ml of one organism was deined as signiicant bacteriuria. At the end of the 8 th week a small piece of the catheter was sent to electromicroscopy to determine the rate of bioilm formation and incrustation. results: Symptomatic urinary tract infection was detected in neither group. The catheter had to be removed prematurely in case of 2 patients in both groups. At the end of the 8 th week signiicant bacteriuria was detected in case of 4 patients (33%) in the UroShield group and in case of 9 patients (81%) in the control group. Signiicant bioilm producing P. aeruginosa wasn’t detected in the UroShield group, while the P. aer. rate was 27% in the control group. In the UroShield group the signiicant E. coli bacteriuria was half that in the control group. The catheter-related complaints decreased by 1.6 in the UroShield group, while they increased by 1.3 in the control group. In case of patients who initially had at least moderate symptoms (≥ 3) there was an decrease of 2.4 points in the UroShield group, while in the control group there was a 2.0-increase after 8-week’s time.