A Randomized and Prospective Study on the Value of Antibiotic Prophylaxis Administration in Transurethral Resection of the Prostate

Overview

Journal Sao Paulo Med J

Specialty General Medicine

Date 2004 May 27

PMID 15160519

Citations 4

Authors

Paulo Rodrigues

Flavio Hering

Alex Meller

Joao Carlos Campagnari

Marcio DImperio

Affiliations

Soon will be listed here.

Abstract

Context: Antibiotic prophylaxis in transurethral resection of the prostate is a regular practice in urology. However, its prophylactic effect can be questioned when the antiseptic surgical technique is used. Nonetheless, urine culture-oriented antibiotic therapy is the gold standard for avoiding improper medication usage and bacterial resistance.

Objective: To study the efficacy of antibiotic usage in patients with negative urine cultures, who were submitted to transurethral resection of the prostate.

Type Of Study: Prospective open labeled study.

Setting: Tertiary care referral hospital.

Participants: 124 consecutive patients, who were randomly divided into two groups to receive antibiotic prophylaxis or not.

Main Measurements: Cultures from meatus, urine, irrigation and antiseptic fluid, and prostate tissue chips, were compared and analyzed for bacterial sensitivity to the antibiotic used, according to the surgeon's personal criteria. McLennan's test was used for statistical analysis.

Results: No statistically significant difference regarding clinical evolution was found between the groups that received or antibiotics or not. Statistical significance was found regarding the occurrence of positive urine cultures during the postoperative period for those not receiving antibiotics, but not in relation to fever, prostate chip culture or bacteremic episodes. Sixty-eight subjects (57.1%) presented positive prostatic tissue culture. There was no specific correlation between the recovered bacteria from the meatus, prostatic tissue chip and urine and the spectrum of the administered antibiotic. Six cases showed the same bacteria in the urine and prostatic tissue chip. Only fifteen cases (25%) in the antibiotic group showed the desired sensitivity directed to the collected bacteria.

Conclusions: Antibiotic prophylaxis for patients whose urine is sterile is debatable in patients who are candidates for transurethral resection of the prostate. Most of the time, the antibiotic agent used is not specific for any of the bacteria recovered from the various sources analyzed.

Citing Articles

Bacteraemia during Transurethral Resection of the Prostate: What Are the Risk Factors and Is It More Common than We Think?.

Mohee A, Gascoyne-Binzi D, West R, Bhattarai S, Eardley I, Sandoe J PLoS One. 2016; 11(7):e0157864.

PMID: 27391962 PMC: 4938130. DOI: 10.1371/journal.pone.0157864.

Assessment of antibiotic prophylaxis prescribing patterns for TURP: A need for Canadian guidelines?.

Lawson K, Rudzinski J, Vicas I, Carlson K Can Urol Assoc J. 2013; 7(7-8):E530-6.

PMID: 24032065 PMC: 3758947. DOI: 10.5489/cuaj.205.

Antibiotic prophylaxis for transurethral urological surgeries: Systematic review.

Alsaywid B, Smith G Urol Ann. 2013; 5(2):61-74.

PMID: 23798859 PMC: 3685747. DOI: 10.4103/0974-7796.109993.

[Antibiotic prophylaxis for patients with transurethral resection of the prostate (TUR-P)].

Schmiedl S, Thurmann P, Roth S Urologe A. 2008; 48(1):66-72.

PMID: 18696036 DOI: 10.1007/s00120-008-1856-5.

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