Is Prophylactic Antimicrobial Treatment Necessary After Hypospadias Repair?

Meir, David Ben; Livne, Pinhas M.

doi:10.1097/01.ju.0000124007.55430.d3

Cited by 53 publications

(56 citation statements)

References 8 publications

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“…6 Our secondary outcome results showed no difference in these complications regardless of preoperative and postoperative antibiotics.…”

Section: Discussionmentioning

confidence: 72%

“…3 Little evidence is currently available regarding the effectiveness of preoperative antibiotics in both stented and stentless repair. 6 In our study, we examined the effect of using preoperative antibiotics in reducing the rate of infection after hypospadias repair.…”

Section: Introductionmentioning

confidence: 99%

“…2 Perioperative and postoperative antibiotics are widely used by pediatric urologists, particularly in hypospadias surgery. 3 The rationale was to reduce the risk of urinary tract infection (UTI) in the early postoperative period following the placement of a catheter, [4][5][6][7][8] Moreover, antibiotics were effective at reducing the risk of meatal stenosis and fistula. 4 Although the potential benefit of antimicrobial prophylaxis is unclear and still controversial, most pediatric urologists administer preoperative and postoperative antibiotics independently of a stent placement.…”

Section: Introductionmentioning

confidence: 99%

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The role of preoperative prophylactic antibiotics in hypospadias repair

Baillargeon

Duan²,

Brzezinski³

et al. 2014

CUAJ

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Introduction: We sought to determine whether the use of preoperative antibiotics is effective in reducing postoperative wound infections and urinary tract infections (UTI) in hypospadias repair. Methods:We retrospectively reviewed all hypospadias repairs performed at the Montreal Children's Hospital between March 2009 and September 2012. All types of primary hypospadias repairs and redo cases were included. Patients with no adequate follow-up or with missing records of antibiotics were excluded. Preoperative antibiotics were given in the form of cefazolin (50 mg/kg intravenously) when appropriate. Postoperative oral antibiotics were administered as decided by the pediatric urologist. Primary outcomes included postoperative wound infection and UTI. Secondary outcomes included the need for reoperation of hypospadias due to urethrocutaneous fistula, meatal stenosis, urethral stricture and wound dehiscence. Results: In total, 157 cases of hypospadias repair were reviewed; of these 7 were excluded due to lack of follow-up. Of the remaining 150 patients, 62 received preoperative antibiotics and 88 did not. The groups were well-matched for age, hypospadias characteristics, type of repair and repair of curvature. The group that received preoperative antibiotics had a significantly higher number of stented cases (82% vs. 52% of the non-preoperative antibiotic group). Two cases of wound infection were reported (1 in the preoperative antibiotic group and 1 in the non-preoperative antibiotic group). There was no symptomatic UTI or culture-demonstrated UTI in either group. Moreover, there was no statistically significant difference between the 2 groups in terms of primary outcomes. The complication rate was 11% (17/150 repairs) and all patients needed reoperation. This study's important limitations include the rarity of studied end points combined with the small sample and the retrospective nature of our study. Conclusion: Our findings do not support the routine use of preoperative antibiotics in hypospadias repair.

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“…6 Our secondary outcome results showed no difference in these complications regardless of preoperative and postoperative antibiotics.…”

Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of preoperative prophylactic antibiotics in hypospadias repair

Baillargeon

Duan²,

Brzezinski³

et al. 2014

CUAJ

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“…Postoperatif dönemde ise kateter alındıktan sonraki 2 günü de kapsayacak şekilde sephaleksin kullanımı ile komplike üriner sistem enfeksiyon oranlarının anlamlı derecede azaldığı gösterilmişir (18) . Baillargeon ve ark.…”

Section: Antibiyotik Kullanımıunclassified

Effective factors for success in hypospadias surgery

Kılıç¹

2016

TCCD

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“…But the randomized studies on this are outdated -31 and 10 years old. 4,5 Our surgical approaches, stents, dressings and postoperative care routines have all evolved dramatically with time. 6 It is time to re-evaluate our prescribing habits for hypospadias surgery.…”

mentioning

confidence: 99%