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Postprostatectomy orchitis: reduction in incidence using perioperative ceftriaxone and postoperative ciprofloxacin
1Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
Abstract:
Postoperative orchitis increases the morbidity and overall hospital stay after prostatectomy. A retrospective review of our initial series of 174 cases revealed an incidence of 6% which is similar to other studies. We reviewed our bacterial flora and antibiogram and subsequently started a prospective study combining peri-operative ceftriaxone and postoperative ciprofloxacin, which we compared to our previous series where we used perioperative ceftriaxone followed by postoperative gentamicin and ampicillin. There was an abolition of orchitis as a consequence and a significant reduction in the rate of wound infection. We conclude that a combination of ceftriaxone and ciprofloxacin is efficacious in reducing the rate of infective complications following prostatectomy. We recommend the use of these or similar drugs based on local microbial flora.
Insights
Postoperative orchitis and wound infections after prostatectomy can be reduced. A new antibiotic regimen combining ceftriaxone and ciprofloxacin effectively prevents these complications, improving patient outcomes.
Area of Science:
- Urology
- Infectious Disease
- Surgical Oncology
Background:
- Postoperative orchitis and wound infections are significant complications following prostatectomy.
- These complications increase patient morbidity and prolong hospital stays.
- Previous treatment regimens showed a 6% incidence of orchitis.
Purpose of the Study:
- To evaluate the efficacy of a new antibiotic regimen in reducing infectious complications after prostatectomy.
- To compare the outcomes of a ceftriaxone and ciprofloxacin regimen with a previous regimen of ceftriaxone, gentamicin, and ampicillin.
Main Methods:
- Retrospective review of 174 cases to establish baseline orchitis incidence.
- Prospective study implementing perioperative ceftriaxone and postoperative ciprofloxacin.
- Comparison of infectious complication rates between the two treatment series.
Main Results:
- Complete abolition of postoperative orchitis was observed with the new regimen.
- Significant reduction in the rate of surgical wound infections.
- The ceftriaxone and ciprofloxacin combination demonstrated superior efficacy.
Conclusions:
- The combination of ceftriaxone and ciprofloxacin is highly effective in preventing infectious complications post-prostatectomy.
- This regimen significantly reduces the incidence of orchitis and wound infections.
- Antimicrobial selection should consider local microbial flora and antibiogram data.