48-Hour Cephradine and Post-prostatectomy Bacteriuria

Abstract

In a randomised, controlled trial of intramuscular cephradine given in a dose of 1 g 6-hourly for 48 h, there was a significant reduction in the incidence of significant bacteriuria after transurethral resection. In contrast, the incidence of significant bacteriuria after open prostatectomy was unchanged. Post-operative complications were reduced in patients who received cephradine. The use of short-term cephradine would appear to be justified.

New Method of Postprostatectomy Bladder Irrigation

“…The incidence of pre-operative bacteriuria showed no significant difference between the two groups and this was similar to the 28% incidence found by Williams et al [3]. There was a higher incidence of pre-operative catheterisation amongst the patients in group 1 and this was reflected in the higher rate of peroperative bacteri uria in this group.…”

“…Urinary tract infection can follow transurethral pros tatectomy [1], The incidence of infection is 5% in those patients with sterile preoperative urine who had been given antibiotics [2], The infection rate was 64% in those patients who had a preoperative untreated infection not given antibiotics [3]. Bacteraemia following transure thral prostatectomy has been reported to occur in be tween 10 and 36% of patients, and septicaemia in 3-4% [2,4], Several attempts to reduce the incidence of postpros tatectomy infection have been made.…”

Short-term prophylaxis with cefotaxime for prostatic surgery

“…3 This new cephalosporin appears safe in an elderly population. Several reports have suggested the beneficial effects of prophylactic antibiotics in transurethral prostatectomy7 s but ours is the first to show a statistical reduction in complications in addition to the effect on urinary organisms.…”

“…We In a previous study a 48-hour regimen of antibiotic prophylaxis with cephradine resulted in a statistically significant reduction in postoperative bacteriuria and a possible but not statistically significant reduction in postoperative complications. 3 We undertook the present trial to determine whether by using the new parenteral cephalosporin cefotaxime, which has a greater spectrum of activity than cephradine, we would reduce postoperative complications. Cefotaxime is more active than cefuroxime and cefoxitin against Gram-negative bacteria as well as being four times as active in vitro as carbenicillin against Pseudomonas aeruginosa strains.4 Cefotaxime is well tolerated by the kidney5 6 and so would be particularly useful in an elderly population, in whom renal function may not always be optimal.…”

Estudio bacteriológico de la orina previa a la cirugía urológica endoscópica

“…En contrapartida, también se ha demostrado que la manipulación del tracto urinario es la principal causa de infecciones urinarias y bacteriemia 6 . Con el paso del tiempo han ido proliferando los estudios que demuestran que la utilización de antibióticos profilácticos en dosis única disminuye el número de complicaciones infecciosas 3,[7][8] , aunque hay autores que defienden la utilización de pautas cortas de antibióti-cos, normalmente durante 2 ó 3 días o hasta la retirada de la sonda [9][10][11][12][13][14][15] . La mejora de las técnicas quirúrgicas, la utilización de circuitos cerrados para el drenaje de la orina y la precoz retirada de la sonda disminuyen la tasa de complicaciones infecciosas.…”