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Published on: September 21, 2015
Antibiotic prophylaxis for transurethral urological surgeries: Systematic review
Basim S Alsaywid1, Grahame H H Smith
1Department of Urology, The Sydney Children's Hospitals Network: Westmead Campus, Sydney, Australia ; Department of Surgery, The Urology Section, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia ; Conjoint Associate Lecturer, University of New South Wales, School of Women's and Children's Health, Sydney, Australia.
Antibiotic prophylaxis effectively prevents urinary tract infections and bacteremia after transurethral urologic procedures. This review of 42 RCTs confirms reduced bacteriuria, symptomatic UTIs, and fever, supporting its use in patients with sterile preoperative urine.
Area of Science:
- Urology
- Infectious Diseases
- Evidence-Based Medicine
Background:
- Urinary tract infections (UTIs) and bacteremia are risks following urological instrumentation.
- The efficacy of antibiotic prophylaxis in preventing these complications is debated.
Purpose of the Study:
- To evaluate the effectiveness of antibiotic prophylaxis in reducing UTIs and bacteremia after transurethral urologic surgeries.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Included adult patients undergoing cystoscopy, transurethral resection of prostate, or transurethral resection of bladder tumor.
- Analyzed outcomes comparing antibiotic prophylaxis versus placebo/no treatment.
Main Results:
- Antibiotic prophylaxis significantly reduced bacteriuria (RR 0.36), symptomatic UTIs (RR 0.38), bacteremia (RR 0.43), and high-grade fever (RR 0.41).
- No significant reduction was observed for low or moderate-grade fever.
- Moderate heterogeneity was noted for bacteriuria, while other outcomes showed minimal to no heterogeneity.
Conclusions:
- Antibiotic prophylaxis is effective in preventing UTIs and associated complications after transurethral urologic procedures in patients with sterile preoperative urine.
- The findings support the use of antibiotic prophylaxis to mitigate infection risks in this patient population.
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