Epidemiology of the Postoperative Bacteriuria and Urinary Tract Infections Following Transurethral Resection of the Prostate
Beatriz Lemos da Silva Mandim *
Department of Anesthesiology, Federal University of Uberlandia - UFU, Uberlandia, Brazil.
Claudia Lemos da Silva
Department of Radiology, Federal University of Uberlandia - UFU, Brazil.
Hugo Cogo-Moreira
Department of Psychiatry and Medical Psychology, Federal University of São Paulo – UNIFESP, Brazil.
Fabíola Prado Moraes
Department of Medical Clinics, Federal University of Uberlandia – UFU, Brazil.
Augusto Diogo-Filho
Department of Surgery, Federal University of Uberlandia - UFU, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: Despite guidelines and recommendations, a pragmatic approach, i.e., that treatment will improve patient-centered outcomes when performed by typical clinicians in typical patients, is necessary to evaluate the effectiveness of antibiotic prophylaxis in urological surgery.
Study Design: Prospective, randomized, double-blinded, pragmatic trial.
Place and Duration: The study was performed in a tertiary hospital at Federal University of Uberlandia, Brazil, from January 2012 to December 2013.
Methods: One hundred and thirty patients were randomly assigned to receive a single dose of 2 g intravenous (IV) ceftriaxone (66 subjects) or 2 g IV cefazolin (64 subjects) thirty minutes before transurethral resection of the prostate (TURP). We evaluated their physical status, preoperative urinary catheter use, urological risk factors, prostate size, and the duration of surgery.
Results: Ceftriaxone showed a non-significant trend towards superiority to cefazolin (OR = 0.567, 95% CI [0.234-1.414], p = 0.228) for the prevention of infections among TURP patients.
Conclusion: No significant difference in the effectiveness of a single dose of ceftriaxone compared with cefazolin for the prevention of postoperative infections was found in patients undergoing TURP following the early postoperative removal of an indwelling catheter. Due to the pragmatic assumptions of this trial, this result might not represent a negative finding; instead, it may indicate the importance of risk factors influencing the patients’ susceptibility to infection.
Keywords: Transurethral resection of prostate, surgical site infection, urinary tract infections, bacteriuria, antibiotic prophylaxis, cefazolin, ceftriaxone