Use of nitrofurantoin macrocrystals after transurethral prostatectomy

A prospective randomized study of 223 consecutive patients with sterile urine undergoing transurethral prostatectomy was undertaken to examine the effects of nitrofurantoin macrocrystals on postoperative urine cultures. Patients were divided into 3 groups; group 1 received no postoperative antibiotics, group 2 received nitrofurantion for 5 days postoperatively and group 3 received nitrofurantoin for 10 days postoperatively. Nitrofurantoin decreases the incidence of short-term (24 hours after catheter removal) postoperative bacteriuria, while having no effect on long-term (4 weeks) bacteriuria following transurethral prostatectomy. The use of postoperative nitrofurantoin is supported by its tendency to reduce the incidence of short-term urinary infection in patients with the same organisms found in cultures of the prostatic tissue. However, there was no long-term advantage in prolonging therapy for greater than 5 days. There was no difference in morbidity in the immediate postoperative period among the 3 groups.