Randomized controlled study of chemoprophylaxis in transurethral prostatectomy

Area of Science:

• Urology
• Infectious Diseases
• Pharmacology

Background:

• Benign prostatic hypertrophy (BPH) is a common condition requiring surgical intervention.
• Transurethral prostatectomy (TURP) is a standard surgical procedure for BPH.
• Postoperative infectious complications following TURP can lead to increased morbidity.

Purpose of the Study:

• To evaluate the efficacy of single-dose antibiotic prophylaxis in preventing infectious complications after TURP.
• To compare the effectiveness of ceftriaxone and trimethoprim-sulfamethoxazole against placebo for infection prevention.

Main Methods:

• A randomized controlled trial involving 599 patients undergoing TURP across 7 urological units.
• Patients were randomized into three groups: single-dose ceftriaxone, trimethoprim-sulfamethoxazole, or no antibiotic prophylaxis (control).
• Exclusion criteria included preoperative catheterization, positive urine culture, active infection, or prior antibiotic treatment.

Main Results:

• Infectious complications occurred in 7.6% of the ceftriaxone group, 12.3% of the trimethoprim-sulfamethoxazole group, and 21.6% of the control group.
• Single-dose ceftriaxone significantly reduced infectious complications compared to the control group (p < 0.01).
• Trimethoprim-sulfamethoxazole also showed a significant reduction in complications compared to the control group (p < 0.05).

Conclusions:

• Single-dose ceftriaxone prophylaxis is effective in preventing serious infectious complications after transurethral prostatectomy.
• Antibiotic prophylaxis, particularly with single-dose ceftriaxone, is a valuable strategy to improve outcomes in TURP patients.