Associated measures to antibiotic prophylaxis in urology

Area of Science:

• Infection Control
• Surgical Safety
• Evidence-Based Medicine

Background:

• Nosocomial infections, particularly urinary tract infections and surgical site infections (SSI), represent a significant healthcare challenge.
• Antibiotic prophylaxis is a standard method for reducing post-operative infection risk, but its effectiveness can be limited by evolving bacterial resistance patterns.

Purpose of the Study:

• To conduct a comprehensive literature review on non-antibiotic measures for reducing post-operative infections.
• To identify and evaluate the efficacy of various interventions aimed at preventing surgical site infections.

Main Methods:

• A systematic literature search was conducted in February 2019 using the Medline database.
• Studies published within the last 10 years were included to account for advancements in surgical techniques and antibiotic resistance.
• A total of 229 studies were identified, with 53 initially selected and 44 ultimately included in the final analysis.

Main Results:

• The review evaluated the effectiveness of multiple interventions for SSI prevention.
• Key measures assessed include skin antisepsis, surgical hand hygiene and technique, surgeon attire (caps), maintenance of normothermia, hair removal practices, enhanced oxygen delivery, wound protectors, pre-operative bathing, glycemic control, and immunonutrition.

Conclusions:

• While antibiotic prophylaxis is important, a range of other measures should be considered by surgical and anesthesia teams to minimize SSI risk.
• Further research is required to definitively establish the efficacy of certain infection prevention strategies, underscoring the need for ongoing investigation.