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Abstract:
The efficacy of prophylaxis for control of infection in prostatectomy was studied in 260 patients in a double-blind clinical trial using a single dose of 300 mg trimethoprim and a placebo. Results in 141 transurethral and 119 patients operated on abdominally were analyzed separately. Neither group showed significant heterogeneity of risk factors. Trimethoprim did not prevent bacteremia during operation. No significant difference in infection between trimethoprim and placebo groups was found in either group. After several studies the efficacy of antimicrobial prophylaxis in prostatectomy still remains to be proved; it may be too low to warrant such a prophylaxis in general.
Insights
Single-dose trimethoprim prophylaxis did not significantly reduce infection rates in prostatectomy patients. Further research is needed to establish the efficacy of antimicrobial prophylaxis for this surgical procedure.
Area of Science:
- Urology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Prostatectomy is a common surgical procedure.
- Post-operative infections are a potential complication.
- Antimicrobial prophylaxis is often used to prevent infections.
Purpose of the Study:
- To evaluate the efficacy of a single dose of trimethoprim for infection prophylaxis in prostatectomy patients.
- To compare outcomes between transurethral and abdominal prostatectomy approaches.
Main Methods:
- A double-blind, placebo-controlled clinical trial.
- 260 prostatectomy patients were enrolled.
- Patients received either 300 mg trimethoprim or a placebo.
Main Results:
- Trimethoprim did not prevent intraoperative bacteremia.
- No significant difference in infection rates was observed between the trimethoprim and placebo groups for either surgical approach.
- Risk factors for infection did not differ significantly between groups.
Conclusions:
- The efficacy of antimicrobial prophylaxis in prostatectomy remains unproven.
- The effectiveness may be too low for general recommendation.
- Further studies are warranted to determine optimal prophylactic strategies.