Prophylactic single-dose prulifloxacin for catheter-associated urinary tract infection after tension-free vaginal tape procedure

Abstract

The purpose of the study was to evaluate whether antibiotic prophylaxis with a single dose of prulifloxacin after tension-free vaginal tape (TVT) procedure decreases catheter-associated urinary tract infections (UTIs). Patients undergoing TVT procedure receiving a single dose of prulifloxacin (600 mg) 10 h before catheter removal (n=54) were compared with historical controls who have had no treatment (n=60). All patients had an indwelling urethral catheter in situ for 24 h. Urine specimens for culture were collected preoperatively, before Foley removal, and 7 days postoperatively in both groups. Main outcome measures were significant bacteriuria and symptomatic UTI at catheter removal and 1 week postoperatively. No patient had a positive urine culture in the prulifloxacin group compared with 14 (23.3%) in the control group at catheter removal (P=0.0001). Ten out of 14 (71.4%) women with a positive catheter urine culture had a symptomatic UTI. One week after surgery no difference was found in the rate of significant bacteriuria between groups. Our data suggest that a prophylactic single dose of prulifloxacin could help to reduce the rate of symptomatic and asymptomatic UTIs after short-term urethral catheterization in women undergoing TVT procedure.

Microbiological Analysis of Urine Cultures in Women after Pelvic Reconstructive Surgery

“…In a retrospective cohort of patients undergoing vaginal reconstructive surgery, prophylactic antibiotics decreased the risk of postoperative UTI in women requiring use of Foley catheterization at time of discharge [17]. This concept is further supported by Ghezzi et al [18] who reported prophylactic single-dose antibiotic therapy may help reduce the rate of UTIs after short-term urethral catheterization in women undergoing tension-free vaginal tape procedure.…”

Urinary tract infection before and after mid-urethral slings: culture-proven diagnosis and analysis of risk factors

“…The value of chemoprophylaxis in lowering the incidence of UTIs in short-term catheterized patients is controversial [21]. Prophylactic chemotherapy may inhibit or promote UTIs.…”

“…This prevalence is lower than previously reported studies. In review by Nygaard and Kreder, UTI rates were estimated at 17-85% after anti-incontinence procedures [21,25]. In a more recent retrospective study, Anger et al reported that 33.6% of patients undergoing a sling procedure experienced an UTI in the first 3 months postoperatively.…”

Urinary tract infection prevention after midurethral slings in pelvic floor reconstructive surgery: A systematic review and meta‐analysis

“…ACOG acknowledges the potential role for antibiotic prophylaxis during postoperative indwelling catheter use but makes no firm recommendation . The two studies examining antibiotic prophylaxis for routine postoperative catheterization did demonstrate a significant benefit in favor of this approach. However, routine prolonged indwelling catheterization is currently rarely needed after isolated MUS or even after MUS with pelvic reconstructive surgery.…”