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Prophylactic antibiotics in transurethral prostatectomy.

N Qvist, H M Christiansen, D Ehlers

    Urological Research
    |January 1, 1984
    PubMed
    Summary
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    Prophylactic antibiotics like cefotaxime are not recommended before transurethral prostatectomy for patients with sterile urine. The study found no significant difference in postoperative urinary infection rates between antibiotic and placebo groups.

    Area of Science:

    • Urology
    • Infectious Diseases
    • Pharmacology

    Background:

    • Transurethral prostatectomy (TURP) is a common procedure.
    • Urinary tract infections (UTIs) can be a postoperative complication.
    • The role of prophylactic antibiotics in preventing UTIs after TURP is debated.

    Purpose of the Study:

    • To evaluate the efficacy of preoperative cefotaxime in preventing postoperative urinary infections after transurethral prostatectomy.
    • To assess the incidence of UTIs and bacterial resistance in patients undergoing TURP.

    Main Methods:

    • A randomized controlled trial involving 88 patients with sterile urine prior to TURP.
    • Patients received either a preoperative dose of cefotaxime (45 patients) or a saline placebo (43 patients).
    • Postoperative urinary infections were monitored, and bacterial cultures and sensitivity testing were performed on infected patients.

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    Main Results:

    • No statistically significant difference in the frequency of postoperative UTIs between the cefotaxime group (13.3%) and the control group (18.6%).
    • All infections in the cefotaxime group were sensitive to the antibiotic, except for one case of enterococcal infection.
    • No bacterial growth was detected in blood or bladder irrigating fluid, and no serious complications were observed.

    Conclusions:

    • Prophylactic preoperative antibiotic treatment with cefotaxime is not indicated for transurethral prostatectomy in patients with sterile urine.
    • The low risk of infection and mild side effects do not justify routine antibiotic prophylaxis.
    • Further research may explore antibiotic stewardship in urological procedures.