S Schmiedl1, P A Thürmann, S Roth. 1. Philipp Klee-Institut für Klinische Pharmakologie, HELIOS Klinikum Wuppertal, Klinikum der Universität Witten/Herdecke, Heusnerstrasse 40, 42283 Wuppertal. sven.schmiedl@helios-kliniken.de
Abstract
BACKGROUND: For patients undergoing urologic interventions, relevant aspects of antibiotic prophylaxis such as drug of choice and duration of prophylaxis are still discussed controversially. According to the current European and German guidelines, single-shot prophylaxis is recommended only in patients with risk factors. METHODS: Discussion of two published meta-analyses with regard to of recently published randomized controlled trials. RESULTS: Two comprehensive meta-analyses concordantly revealed a significant reduction in bacteriuria and fever incidence without stratification according to preexisting risk factors. A single antibiotic dose ("single shot") of, for example, a cephalosporin or chinolone reduced the bacteriuria rate significantly. However, for the cephalosporines, the most frequently studied drug class, repeated dosing seems to be more effective. CONCLUSION: Antibiotic prophylaxis reduces the rates of bacteriuria and fever in patients without existing risk factors undergoing transurethral resection of the prostate. The optimal duration of antibiotic prophylaxis and the drug of choice must be evaluated in further studies investigating clinically relevant endpoints.
BACKGROUND: For patients undergoing urologic interventions, relevant aspects of antibiotic prophylaxis such as drug of choice and duration of prophylaxis are still discussed controversially. According to the current European and German guidelines, single-shot prophylaxis is recommended only in patients with risk factors. METHODS: Discussion of two published meta-analyses with regard to of recently published randomized controlled trials. RESULTS: Two comprehensive meta-analyses concordantly revealed a significant reduction in bacteriuria and fever incidence without stratification according to preexisting risk factors. A single antibiotic dose ("single shot") of, for example, a cephalosporin or chinolone reduced the bacteriuria rate significantly. However, for the cephalosporines, the most frequently studied drug class, repeated dosing seems to be more effective. CONCLUSION: Antibiotic prophylaxis reduces the rates of bacteriuria and fever in patients without existing risk factors undergoing transurethral resection of the prostate. The optimal duration of antibiotic prophylaxis and the drug of choice must be evaluated in further studies investigating clinically relevant endpoints.
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