Single-Dose Antibiotic Prophylaxis in Transurethral Resection of the Prostate: A Prospective Randomized Trial

Scholz, Michael; Lüftenegger, Werner; Harmuth, H; Wolf, D.; Höltl, W.

doi:10.1016/s0022-5347(01)61752-x

Cited by 11 publications

(18 citation statements)

References 3 publications

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“…However, the incidence of bacteriuria after TURP is considerably higher, at 24%[1] to 64%[2] in patients with sterile urine, and where there was no indwelling bladder catheter present before TURP. Several authors reported a beneficial effect of prophylactic antibiotics for these patients undergoing TURP [1,4,5]. The presence of an indwelling catheter significantly increased the incidence of bacteriuria before and after TURP, by up to 53% and 100%, respectively [8].…”

Section: Discussionmentioning

confidence: 99%

“…One dose of prophylactic antibiotic at the time of surgery in patients with preoperatively sterile urine and no catheter significantly reduces the incidence of bacteriuria afterward [4] compared with no antibiotic prophylaxis. A 48‐h course of prophylactic antibiotic is also beneficial [10], and indeed was deemed to be better than a single dose in a study by Hargreaves et al [11].…”

Section: Discussionmentioning

confidence: 99%

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The catheterized patient undergoing transurethral resection of the prostate: a survey of the current practice of British urologists

Wilson¹,

Puri²,

Urwin³

2003

BJU International

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handbook of the British Association of Urological Surgeons (1998). A hypothetical situation in the opening statement proposed 'a patient with an indwelling catheter is to undergo TURP' . The type, timing and duration of prophylactic antibiotic usage were elicited by circling the appropriate response from a choice of several possibilities. RESULTSIn all, 250 questionnaires were returned; 98% of respondents recognized the importance of the prophylactic use of antibiotics in catheterized patients undergoing TURP, and routinely use them. Most urologists (53%) use more than one dose, with most of these preferring a second dose on catheter removal (60%). CONCLUSIONThe magnitude and diversity of response suggests uncertainty about the appropriate prophylaxis in such patients, and the need for further studies to clarify this situation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The catheterized patient undergoing transurethral resection of the prostate: a survey of the current practice of British urologists

Wilson¹,

Puri²,

Urwin³

2003

BJU International

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“…Additionally, these rates may be reduced by using proper antibiotic prophylaxis with cefuroxime or ceftazidime. Scholz et al [16] showed that single-dose antibiotic prophylaxis with 1 g of ceftriaxone intravenously is effective in patients undergoing TURP. In another study [7] , it was recommended that at least patients at risk of infection should receive antibiotic prophylaxis prior to TURP.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Randomized and Placebo-Controlled Study for the Evaluation of Antibiotic Prophylaxis in Transurethral Resection of the Prostate

Öztürk¹,

Koca²,

Kaya³

et al. 2007

Urol Int

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Aim: To evaluate the risk of bacteriuria after transurethral resection of the prostate and the preventive effects of different kinds of antibiotics. Patients and Methods: Urine was collected for culturing 1 week before the operation and on postoperative days 2 and 10. The patients were divided into four groups: group 1 patients were given a first-generation cephalosporin (cefazolin 1 g), group 2 patients received a second-generation cephalosporin (cefuroxime 750 mg), group 3 patients were given a third-generation cephalosporin (ceftazidime 1 g), and group 4 patients received a placebo. Results: The 2nd-day postoperative bacteriuria rates were similar in all groups. On the 10th day, the incidence rates of bacteriuria in group 4 and group 1 patients were 40 and 31%, respectively (p = 0.661). In group 2, the bacteriuria incidence rate was 6.6%, and when compared with the placebo group, the difference was considered significant (p = 0.002). The difference between group 3 and group 4 was also significant (p = 0.003). There were statistically significant differences between group 1 and group 2 (p = 0.008) and between group 1 and group 3 (p = 0.01). Conclusions: Our study demonstrated that postoperative bacteriuria incidence rates are high, even in patients who underwent transurethral resection of the prostate with sterile urine, but it can be reduced by using antibiotic prophylaxis with cefuroxime or ceftazidime.

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“…Hay autores que recomiendan únicamente monodosis 3,[7][8]20 , otros apuestan por una pauta corta 9-13 mientras que otros utilizan pautas de antibióticos largas 14,15 . Grabe 23 observa una reducción del 35 al 10% de bacteriurias postoperatorias manteniendo el antibiótico hasta 5 días después de retirar la sonda al compararlo con el mismo antibiótico hasta la retirada de la sonda.…”

Section: Familias Bacterianasunclassified

“…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.…”

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Estudio bacteriológico de la orina previa a la cirugía urológica endoscópica

et al. 2005

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Objetivo: Los objetivos de este estudio son conocer la incidencia de bacteriuria preoperatoria en pacientes que van a ser sometidos a intervenciones urológicas por vía endoscópica, analizar los microorganismos más frecuentes que aparecen en los cultivos y sus resistencias a los antibióticos, para así seleccionar el antibiótico profiláctico más apropiado para nuestra población y determinar qué factores de riesgo están relacionados con la aparición de bacteriuria o sepsis urinaria en el postoperatorio.Material y Método: Se incluyeron en el estudio a 449 pacientes a los que se les iba a someter a cirugía urológica endoscópi-ca. Se recogieron muestras de orina para su cultivo antes de la administración del antibiótico profiláctico y se volvieron a tomar a la semana de retirar la sonda vesical, ya sin tratamiento antibiótico. Se analizaron las variables que podían estar relacionadas con la mayor incidencia de complicaciones infecciosas. Se prestó especial atención a las incidencias del postoperatorio, y sobre todo, a las de naturaleza infecciosa.Resultados: Se detectó bacteriuria preoperatoria en 66 de 428 pacientes (15,4%). Esta se asoció a la edad, el sexo, la historia de infecciones previas, la existencia de diabetes mellitus, la presencia de sonda vesical y a la patología que indicaba la intervención quirúrgica. El tipo de microorganismo más frecuente fue Escherichia coli (43,1%). En el 37,9% de los pacientes con bacteriuria preoperatoria el microorganismo fue resistente al antibiótico utilizado profilácticamente para la intervención quirúrgica. Apareció bacteriuria postoperatoria en el 22% de los pacientes, lo que se asoció únicamente a la presencia de bacteriuria preoperatoria. El 2,9% de los pacientes tuvieron criterios de sepsis de origen urinario durante la estancia hospitalaria. La sepsis se asoció únicamente a la duración de la cirugía y no a la presencia de bacteriuria preoperatoria, ni con los días de permanencia de la sonda, y ni a la utilización, en estos casos, de un antibiótico profiláctico "no apropiado".Conclusión: Una parte importante de los pacientes sometidos a cirugía endoscópica presentan bacteriuria preoperatoria, aunque fue responsable de la bacteriuria posoperatoria en menos del 25% de los casos. La duración de la cirugía parece ser la única causa relacionada con la sepsis de origen urinario.Palabras clave: Cirugía endoscópica. Bacteriuria. Sepsis urinaria. Profilaxis antibiótica. ABSTRACT URINARY BACTERIOLOGIC STUDY PRIOR TO ENDOSCOPIC UROLOGIC SURGERYObjective: The objectives of this study are to know the incidence of preoperative bacteriuria in patients undergoing endoscopic urologic surgery, to analyze the most frequent microorganisms appearing in the cultures and their resistance to antibiotics in order to select the most appropriate prophylactic one for our population, and to determine the risk factors related to postoperative bacteriuria or sepsis of urologic origin.Material and Methods: 449 patients undergoing endoscopic urologic surgery were included in the study. Urinary samples w...

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Single-Dose Antibiotic Prophylaxis in Transurethral Resection of the Prostate: A Prospective Randomized Trial

Cited by 11 publications

References 3 publications

The catheterized patient undergoing transurethral resection of the prostate: a survey of the current practice of British urologists

The catheterized patient undergoing transurethral resection of the prostate: a survey of the current practice of British urologists

A Prospective Randomized and Placebo-Controlled Study for the Evaluation of Antibiotic Prophylaxis in Transurethral Resection of the Prostate

Estudio bacteriológico de la orina previa a la cirugía urológica endoscópica

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