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PROPHYLATIC ANTIBIOTIC USE IN TRANSURETHRAL PROSTATIC RESECTION: A META-ANALYSIS

2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 2 Part 1 Linguagem: Inglês

10.1016/s0022-5347(01)69088-8

1527-3792

Alexander Berry, Alexandra Barratt,

Urinary Tract Infections Management

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2002PROPHYLATIC ANTIBIOTIC USE IN TRANSURETHRAL PROSTATIC RESECTION: A META-ANALYSIS ALEXANDER BERRY and ALEXANDRA BARRATT ALEXANDER BERRYALEXANDER BERRY and ALEXANDRA BARRATTALEXANDRA BARRATT View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)69088-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We reviewed the efficacy of antibiotic prophylaxis in men undergoing transurethral prostatic resection, a clean contaminated procedure. Materials and Methods: We systematically reviewed randomized controlled trials of antibiotic prophylaxis for transurethral prostatic resection with a meta-analysis of the results. We identified 32 randomized controlled trials with 4,260 participants examining the postoperative bacteriuria incidence. An 8-trial subset with 1,979 participants examined postoperative septicemia occurrence. Results: Prophylactic antibiotic use in patients at low risk undergoing transurethral prostatic resection significantly decreased bacteriuria and clinical septicemia incidence. The bacteriuria incidence decreased from 26% to 9.1% (relative risk reduction 65%, 95% confidence interval −56 to −73). The clinical septicemia incidence decreased from 4.4% to 0.7% (relative risk reduction 77%, 95% confidence interval −55 to −88). Effective antibiotic classes included quinolones, cephalosporins, co-trimoxazole and aminoglycosides. Treatment protocols of any duration were effective. Subgroup analysis of cephalosporin based trials indicated that short treatment protocols appeared more effective than single dose protocols. Based on these results if 1,000 patients with sterile urine undergoing transurethral prostatic resection were given prophylactic antibiotics, bacteriuria would be avoided in 175, while septicemia would be prevented in 9 to 20. Conclusions: Antibiotic prophylaxis significantly decreases the incidence of bacteriuria and clinical septicemia in men with preoperative sterile urine undergoing transurethral prostatic resection. A significant decrease in bacteriuria incidence can be achieved with a range of antibiotic agents, including quinolones, cephalosporins and co-trimoxazole. Short course antibiotic protocols may be more effective than single dose regimens. References 1 : Appropriate surgical prophylaxis in transurethral genitourinary surgery and potential reduction in nosocomial infections. Urology1986; 27: 415. Crossref, Medline, Google Scholar 2 : Urinary infections following transurethral resection of bladder tumors. Rate and source. J Urol1983; 129: 1123. 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Volume 167Issue 2 Part 1February 2002Page: 571-577 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsprostatebiopsyantibiotic prophylaxisbacteriuriasepticemiaMetrics Author Information ALEXANDER BERRY More articles by this author ALEXANDRA BARRATT More articles by this author Expand All Advertisement PDF downloadLoading ...